Individual
BRUCE EDWIN CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
6607 SABROSA CT E, FT WORTH, TX 76133-5251
(903) 654-0784
Mailing address
PO BOX 331535, FT WORTH, TX 76163-1535
(903) 654-0784
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
73166
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73166
LICENSED PROFESSIONAL COUNSELOR
TX
Enumeration date
05/11/2022
Last updated
05/11/2022
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