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General NPI Number Information
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NPI Number | 1740646926
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Entity Type | Organization
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Legal Business Name | TITANIUM COUNSELING PLLC
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 675 TOWN SQUARE BLVD SUITE 200, BLDG 1A
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City | GARLAND
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State | TX
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Zip | 75040-2992
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Country | US
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Telephone | 972-768-9653
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Fax | 214-299-7601
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Provider Business Mailing Address
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Address Line | 675 TOWN SQUARE BLVD SUITE 200, BLDG 1A
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City | GARLAND
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State | TX
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Zip | 75040-2992
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Country | US
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Telephone | 972-768-9653
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Fax | 214-299-7601
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Authorized Official
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Title or Position | PRESIDENT
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Name | GORDON LANCE MUNN
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Credential | LCSW
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Telephone | 972-768-9653
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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 | 22687
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License Number State | TX
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