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General NPI Number Information
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NPI Number | 1790157477
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Entity Type | Organization
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Legal Business Name | SEGNIAN BH SERVICES LLC
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Dates
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Enumeration Date | 10/21/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 133 CHIEFTAIN DR SUITE 102
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1580
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Country | US
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Telephone | 817-707-5681
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 447
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City | PALMER
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State | TX
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Zip | 75152
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Country | US
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Telephone | 817-707-5681
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANITA ELLEN DUKE
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Credential |
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Telephone | 817-707-5681
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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 |
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License Number State |
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