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General NPI Number Information
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NPI Number | 1659558146
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Entity Type | Organization
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Legal Business Name | AFFECT GROUP, INC.
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 10300 N CENTRAL EXPY SUITE 172
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 214-520-7007
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Fax | 214-361-1929
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Provider Business Mailing Address
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Address Line | 10300 N CENTRAL EXPY SUITE 172
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 214-520-7007
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Fax | 214-361-1929
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DR. MICHELLE LEE YOUNG
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Credential | PHD
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Telephone | 214-520-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 35485
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License Number State | TX
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