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General NPI Number Information
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NPI Number | 1659683399
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Entity Type | Organization
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Legal Business Name | DYNAMIC COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 5503 CANYON BLUFF CT
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City | ROSHARON
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State | TX
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Zip | 77583-2090
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Country | US
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Telephone | 832-891-9355
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Fax | 281-972-9809
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Provider Business Mailing Address
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Address Line | 5503 CANYON BLUFF CT
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City | ROSHARON
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State | TX
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Zip | 77583-2090
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Country | US
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Telephone | 832-891-9355
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Fax | 281-972-9809
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Authorized Official
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Title or Position | LCSW
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Name | MS. PATRICIA A. TADEMY
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Credential | CSW
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Telephone | 832-891-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 20106
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License Number State | TX
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