Organization
THE FULL FRUIT EMPOWERMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELORA EVANS MA, LPC-S, LCDC, SAP (OWNER/CEO/ EXE DIR)
(469) 766-1251
Entity
Organization
Contact information
Practice address
4650 S HAMPTON RD STE 119, DALLAS, TX 75232-1061
(682) 557-4695
Mailing address
1512 CHAMA DR, FORT WORTH, TX 76119-2666
(469) 766-1251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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