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Organization
PSY FAMILY SERVICES
Active
Organization
PSY FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EZIO LEITE LPC (OWNER)
(817) 338-4471
Entity
Organization
Contact information
Practice address
159 N RIVERSIDE DR, FORT WORTH, TX 76111-3911
(817) 338-4471
(817) 338-1811
Mailing address
159 N RIVERSIDE DR, FORT WORTH, TX 76111-3911
(817) 338-4471
(817) 338-1811
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/26/2010
Last updated
06/07/2010
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