MEDICARE: ANBER LANTZ CRC, NCC, LPC-INTERN

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	101YP2500X	Professional Counselor	75735	TX

General Provider Information

NPI Number	:	1205299690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANBER LANTZ CRC, NCC, LPC-INTERN

Provider Business Mailing Address
First Line	:	9262 FOREST LN
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75243-4207
Country	:	US
Telephone Number	:	214-692-5001
Fax Number	:

Provider Business Practice Location Address
First Line	:	9262 FOREST LN
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75243-4207
Country	:	US
Telephone Number	:	214-692-5001
Fax Number	:

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

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	04/01/2016

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Directions to “ ANBER LANTZ CRC, NCC, LPC-INTERN” Practice Location

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