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General NPI Number Information
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NPI Number | 1639654890
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Entity Type | Individual
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Provider Name | CORRIE A FENTRESS MS, LMFT ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 723 S INTERSTATE 35 E
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City | DENTON
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State | TX
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Zip | 76205-4101
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Country | US
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Telephone | 940-331-6192
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 SHORELINE DR STE 151
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City | DENTON
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State | TX
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Zip | 76210-0176
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203059
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License Number State | TX
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