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General NPI Number Information
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NPI Number | 1639769490
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Entity Type | Organization
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Legal Business Name | AMERICAN BEHAVIOR CHANGE CENTER LLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 4514 COLE AVE STE 600
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City | DALLAS
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State | TX
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Zip | 75205-4193
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Country | US
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Telephone | 703-342-9329
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Fax |
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Provider Business Mailing Address
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Address Line | 8324 LULLWATER DR
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City | DALLAS
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State | TX
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Zip | 75218-1148
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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 | OPERATIONS MANAGER
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Name | DONNA SCOTT
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Credential |
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Telephone | 214-621-3485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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