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General NPI Number Information
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NPI Number | 1962533489
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Entity Type | Individual
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Provider Name | DOUGLAS BELLAMY EDD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 17762 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75252-5736
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Country | US
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Telephone | 972-404-8888
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Fax | 972-208-2412
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Provider Business Mailing Address
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Address Line | PO BOX 940165
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City | PLANO
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State | TX
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Zip | 75094-0165
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Country | US
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Telephone | 972-424-9212
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Fax | 972-509-1450
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 21998
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License Number State | TX
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