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General NPI Number Information
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NPI Number | 1760967202
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Entity Type | Individual
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Provider Name | THENESSA MACK PALMER LPC
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Gender | Female
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 2909 TURNER WARNELL RD # 131
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City | ARLINGTON
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State | TX
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Zip | 76001-7727
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Country | US
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Telephone | 817-969-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 2909 TURNER WARNELL RD STE 131
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City | ARLINGTON
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State | TX
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Zip | 76001-7746
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Country | US
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Telephone | 682-593-2530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 73775
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License Number State | TX
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