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General NPI Number Information
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NPI Number | 1912349101
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Entity Type | Organization
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Legal Business Name | GARY SOSBEE LLC
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 1010 W JASPER DR STE 4
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City | KILLEEN
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State | TX
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Zip | 76542-1328
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Country | US
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Telephone | 214-448-1122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1331
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City | BELTON
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State | TX
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Zip | 76513-5331
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Country | US
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Telephone | 214-448-1122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GARY SOSBEE
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Credential | NCC, LPC, LCDC
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Telephone | 214-448-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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