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General NPI Number Information
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NPI Number | 1750757225
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Entity Type | Organization
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Legal Business Name | MARILEE J. BLOCK, MA, LPC, PLLC
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 508 GRACE ST
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City | WAXAHACHIE
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State | TX
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Zip | 75165-3046
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Country | US
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Telephone | 214-301-2974
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Fax | 972-923-3886
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Provider Business Mailing Address
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Address Line | 4836 FM 813
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City | WAXAHACHIE
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State | TX
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Zip | 75165-8910
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Country | US
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Telephone | 214-301-2974
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR : MANAGER
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Name | MARILEE JANE BLOCK
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Credential | LPC, PLLC
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Telephone | 214-301-2974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 68519
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License Number State | TX
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