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General NPI Number Information
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NPI Number | 1972494938
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Entity Type | Individual
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Provider Name | CHANTAL MARIE BOUSQUET LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 5899 PRESTON RD STE 1201
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City | FRISCO
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State | TX
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Zip | 75034-9594
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Country | US
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Telephone | 214-618-0461
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Fax |
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Provider Business Mailing Address
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Address Line | 3964 STATE HIGHWAY 121 APT 5091
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City | LEWISVILLE
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State | TX
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Zip | 75056-6961
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Country | US
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Telephone | 413-265-7118
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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 | 105533
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License Number State | TX
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