MEDICARE: MICHELLE FERNANDEZ RHYNES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	201937	TX
2	101YP2500X	Professional Counselor	69767	TX

General Provider Information

NPI Number	:	1073053112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE FERNANDEZ RHYNES

Provider Business Mailing Address
First Line	:	3200 N MACARTHUR BLVD STE 101
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-4404
Country	:	US
Telephone Number	:	469-844-0382
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 N MACARTHUR BLVD STE 101
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-4404
Country	:	US
Telephone Number	:	469-844-0382
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2017
Last Update Date	:	11/30/2022

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