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Individual

MR. DWAYNE MICHAEL COX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCDC

Contact information

Practice address
1121 E SOUTHEAST LOOP 323, SUITE 105, TYLER, TX 75701-9660
(903) 509-4232
(903) 509-9918
Mailing address
1121 E SOUTHEAST LOOP 323, SUITE 105, TYLER, TX 75701-9660
(903) 509-4232
(903) 509-9918

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
877
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7856
INTERNATIONAL CERTIFICATE
TX
01
877
LCDC
TX
Enumeration date
11/28/2006
Last updated
07/08/2007
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