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General NPI Number Information
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NPI Number | 1639317068
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Entity Type | Individual
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Provider Name | COREY DAVID ALLAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 6951 VIRGINIA PKWY SUITE 320
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City | MCKINNEY
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State | TX
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Zip | 75071-5713
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Country | US
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Telephone | 214-629-6133
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Fax |
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Provider Business Mailing Address
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Address Line | 6951 VIRGINIA PKWY SUITE 320
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City | MCKINNEY
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State | TX
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Zip | 75071-5713
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Country | US
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Telephone | 214-629-6133
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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 | 18693
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 200944
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License Number State | TX
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