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General NPI Number Information
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NPI Number | 1902145899
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Entity Type | Organization
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Legal Business Name | BUILDING BRIDGES COUNSELING
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 331 MELROSE DR SUITE 105
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City | RICHARDSON
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State | TX
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Zip | 75080-4405
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Country | US
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Telephone | 972-898-1318
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 CLOVERDALE DR
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City | RICHARDSON
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State | TX
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Zip | 75080-4801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | MR. DAVID MORA
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Credential |
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Telephone | 972-898-1318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 18919
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License Number State | TX
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