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General NPI Number Information
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NPI Number | 1790256097
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Entity Type | Organization
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Legal Business Name | ALICE ELIZABETH WARD
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Dates
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Enumeration Date | 12/12/2018
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 104 SOUTH WISTERIA STREET
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 214-505-5194
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 E DEBBIE LANE STE. 102 PMB 209
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 214-505-5194
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. ALICE ELIZABETH WARD
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Credential |
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Telephone | 214-505-5194
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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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