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NPI Code Detail

MEDICARE: HAILEE LABRUM

MEDICARE: HAILEE LABRUM
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
11041C0700XClinical Social Worker12309983-3501UT
21041C0700XClinical Social Worker110146TX

General Provider Information

NPI Number : 1184323537
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAILEE LABRUM
Provider Business Mailing Address
First Line : 2300 ROCKBROOK DR STE A
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-8179
Country : US
Telephone Number : 940-208-8888
Fax Number :
Provider Business Practice Location Address
First Line : 2300 ROCKBROOK DR STE A
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-8179
Country : US
Telephone Number : 940-208-8888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2023
Last Update Date : 08/13/2023

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Directions to “ HAILEE LABRUM ” Practice Location

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