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General NPI Number Information
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NPI Number | 1619273661
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Entity Type | Individual
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Provider Name | MR. ANDREW LEONARD MORAN
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Gender | Male
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 9202 ELAM RD
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City | DALLAS
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State | TX
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Zip | 75217-4151
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Country | US
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Telephone | 214-266-1650
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Fax | 214-266-1824
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Provider Business Mailing Address
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Address Line | 608 VERNET ST
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City | RICHARDSON
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State | TX
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Zip | 75080-4232
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Country | US
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Telephone | 469-556-4902
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19370
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License Number State | TX
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