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General NPI Number Information
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NPI Number | 1972183119
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Entity Type | Organization
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Legal Business Name | WYSONG ENTERPRISES, PLLC
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 4040 N CENTRAL EXPY STE 210
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City | DALLAS
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State | TX
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Zip | 75204-3868
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Country | US
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Telephone | 214-906-5138
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Fax |
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Provider Business Mailing Address
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Address Line | 7424 AZALEA LN
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City | DALLAS
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State | TX
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Zip | 75230-3640
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Country | US
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Telephone | 214-906-5138
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MRS. ERIN L WYSONG-WAREN
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Credential | LPC-S
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Telephone | 214-906-5138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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