MEDICARE: MARRIAGE IS A BUSINESS- CENTER FOR THERAPY AND EDUCATION

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	103T00000X	Psychologist	2-3007	TX

General Provider Information

NPI Number	:	1801138649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARRIAGE IS A BUSINESS- CENTER FOR THERAPY AND EDUCATION

Provider Business Mailing Address
First Line	:	2301 OHIO DR STE 202
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-3902
Country	:	US
Telephone Number	:	972-985-1424
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 OHIO DR STE 202
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-3902
Country	:	US
Telephone Number	:	972-985-1424
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. VIRGINIA S SECREST
Credential	:	PHD
Telephone Number	:	972-985-1424

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	03/19/2013

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