# SOTM LIFE SKILLS CENTER, LLC

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

## Provider details

- **NPI number:** 1578979027
- **Authorized official:** MS. DOMINIQUE DOR LPC (LICENSED PROFESSIONAL COUNSELOR)
- **Authorized official phone:** (972) 709-1180

## Contact information

- **Practice address:** 549 W WHEATLAND RD, DUNCANVILLE, TX 75116-4515
- **Practice address phone:** (972) 709-1180
- **Practice address fax:** (972) 709-1180
- **Mailing address:** 549 W WHEATLAND RD, DUNCANVILLE, TX 75116-4515
- **Mailing address phone:** (972) 709-1180
- **Mailing address fax:** (972) 709-1180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 66598 | TX | Yes |

## Other

- **Enumeration date:** 07/05/2014
- **Last updated:** 07/05/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3286940 | — | TX |