Theresa Braddy
Counselor, Professional in Lewisville, TX. Individual provider (NPI-1).
NPI number1780131417
StatusActive
Last updated in NPPESSep 11, 2016
Details
- NPI
- 1780131417
- Entity type
- Individual (NPI-1)
- Name
- Theresa Braddy
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 11, 2016
- Last updated
- Sep 11, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 68047 | TX | Yes |
Practice location
160 E Vista Ridge Mall Dr1415
Lewisville, TX 75067-3716
Phone 214-531-0747 · Fax 210-519-0316
Mailing address
1278 Fm 407Suite 109 Office #22
Lewisville, TX 75077-2200
Phone 214-513-0747 · Fax 210-519-0316
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