Individual
AHILLAN SIVAKUMARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
7535 OAKMONT BLVD, FORT WORTH, TX 76132-4236
(800) 972-0643
(214) 279-5032
Mailing address
1032 MADELIA AVE, FORT WORTH, TX 76177-1072
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
73197
TX
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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