Mamie Leann Flynn
Counselor, Addiction (Substance Use Disorder) in Fort Worth, TX. Individual provider (NPI-1).
NPI number1699434530
StatusActive
Last updated in NPPESDec 8, 2021
Details
- NPI
- 1699434530
- Entity type
- Individual (NPI-1)
- Name
- Mamie Leann Flynn
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 8, 2021
- Certification date
- Dec 8, 2021
- Last updated
- Dec 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Other names
- Mamie Leann Hicks,loiselle (Former Name)
Practice location
3840 Hulen StFort Worth, TX 76107-7277
Phone 817-335-3022
Mailing address
Po Box 2603Fort Worth, TX 76113-2603
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