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General NPI Number Information
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NPI Number | 1992164115
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Entity Type | Organization
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Legal Business Name | OCD AND ANXIETY SPECIALISTS OF DALLAS,INC.
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Dates
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Enumeration Date | 02/16/2016
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 375 MUNICIPAL DR SUITE 230
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City | RICHARDSON
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State | TX
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Zip | 75080
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Country | US
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Telephone | 214-368-6999
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Fax | 972-643-9394
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Provider Business Mailing Address
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Address Line | 375 MUNICIPAL DR STE 230
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City | RICHARDSON
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State | TX
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Zip | 75080-3624
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Country | US
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Telephone | 214-368-6999
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Fax | 972-643-9394
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | DR. KIMBERLY EVONNE ROCKWELL-EVANS
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Credential | PH.D.
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Telephone | 214-368-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LPC 8758
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License Number State | TX
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