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NPI 1881041101

NPI 1881041101 : REBECCA CHESNEY : DESOTO, TX

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General NPI Number Information
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    NPI Number           |    1881041101
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA CHESNEY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/17/2016
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    Last Update Date     |    05/17/2016
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Provider Practice Location Address
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    Address Line         |    413 TEN MILE DR 
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    City                 |    DESOTO
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    State                |    TX
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    Zip                  |    75115-3805
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    Country              |    US
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    Telephone            |    214-727-6967
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    413 TEN MILE DRIVE 
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    City                 |    DESOTO
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    State                |    TX
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    Zip                  |    75115
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    Country              |    US
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    Telephone            |    214-727-6967
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    69520
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    License Number State |    TX
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