Individual
JACY RADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-INTERN
Contact information
Practice address
9026 GARLAND RD, DALLAS, TX 75218-3919
(817) 880-4383
Mailing address
2362 OLDBRIDGE DR, DALLAS, TX 75228-5360
(817) 880-4383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
73765
TX
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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