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NPI Code Detail

MEDICARE: JOURNEY PSYCHOLOGICAL AND COACHING SERVICES

MEDICARE: JOURNEY PSYCHOLOGICAL AND COACHING SERVICES
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
1251S00000XCommunity/Behavioral Health AgencyTX

General Provider Information

NPI Number : 1295113652
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOURNEY PSYCHOLOGICAL AND COACHING SERVICES
Provider Business Mailing Address
First Line : 509 ROCKY SPRINGS DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7755
Country : US
Telephone Number : 870-489-9780
Fax Number :
Provider Business Practice Location Address
First Line : 509 ROCKY SPRINGS DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75071-7755
Country : US
Telephone Number : 870-489-9780
Fax Number :
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : DR. LASHONDA F WOOTEN
Credential : PSY.D
Telephone Number : 870-489-9780
Provider Enumeration Date : 05/18/2015
Last Update Date : 05/18/2015

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Directions to “JOURNEY PSYCHOLOGICAL AND COACHING SERVICES ” Practice Location

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