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NPI Code Detail

MEDICARE: HEATHER DAWN PEREZ TROWBRIDGE LPC

MEDICARE: HEATHER DAWN PEREZ TROWBRIDGE LPC
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
1101YP2500XProfessional Counselor71867TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396102356
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER DAWN PEREZ TROWBRIDGE LPC
Provider Business Mailing Address
First Line : 6777 CAMP BOWIE BLVD STE 229
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7157
Country : US
Telephone Number : 682-231-1456
Fax Number : 817-887-1694
Provider Business Practice Location Address
First Line : 6777 CAMP BOWIE BLVD STE 229
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7157
Country : US
Telephone Number : 682-231-1456
Fax Number : 817-887-1694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2016
Last Update Date : 10/19/2020

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Directions to “ HEATHER DAWN PEREZ TROWBRIDGE LPC” Practice Location

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