MEDICARE: SAVANNAH SPIKES

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1265116222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNAH SPIKES

Provider Business Mailing Address
First Line	:	5787 S HAMPTON RD STE 230B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-2255
Country	:	US
Telephone Number	:	214-723-4082
Fax Number	:	972-863-9060

Provider Business Practice Location Address
First Line	:	2026 CEDAR VALLEY LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-2306
Country	:	US
Telephone Number	:	214-558-0236
Fax Number	:

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

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	06/12/2023

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Directions to “ SAVANNAH SPIKES ” Practice Location

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