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General NPI Number Information
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NPI Number | 1801246673
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Entity Type | Organization
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Legal Business Name | TAMARA ALLEN-WOLF, LLC
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 2217 MARTIN DR., STE 200
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City | BEDFORD
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State | TX
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Zip | 76021
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Country | US
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Telephone | 817-713-7223
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Fax | 817-358-6980
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Provider Business Mailing Address
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Address Line | 2217 MARTIN DR STE 200
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City | BEDFORD
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State | TX
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Zip | 76021-6249
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Country | US
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Telephone | 817-713-7223
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Fax | 817-358-6980
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MS. TAMARA DAWN ALLEN
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Credential | LPC-S, NCC, CSAT
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Telephone | 817-713-7223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15194
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License Number State | TX
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