# MARRIAGE FULLY ALIVE LLC

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

## Provider details

- **NPI number:** 1891933222
- **Authorized official:** DR. COREY DAVID ALLAN (OWNER)
- **Authorized official phone:** (214) 629-6133

## Contact information

- **Practice address:** 1506 N GREENVILLE AVE STE 250, ALLEN, TX 75002-8692
- **Practice address phone:** (214) 629-6133
- **Practice address fax:** (972) 943-7128
- **Mailing address:** 1506 N GREENVILLE AVE STE 250, ALLEN, TX 75002-8692
- **Mailing address phone:** (214) 629-6133
- **Mailing address fax:** (972) 943-7128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 2200944 | TX | Yes |

## Other

- **Enumeration date:** 01/22/2009
- **Last updated:** 01/22/2009