# BENTLEY FAMILY THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417300526
- **Authorized official:** JACQUELINE B BENTLEY PHD (CEO)
- **Authorized official phone:** (972) 552-5559

## Contact information

- **Practice address:** 713 W BROAD ST, 200, FORNEY, TX 75126-9147
- **Practice address phone:** (972) 552-5559
- **Practice address fax:** (972) 552-5499
- **Mailing address:** PO BOX 2311, FORNEY, TX 75126-2311
- **Mailing address phone:** (972) 552-5559
- **Mailing address fax:** (972) 552-5499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2016
- **Last updated:** 07/13/2016