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Organization

DOUGLAS R CHEATHAM

Active
Other names
Ellis County Family Services
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOUGLAS RAY CHEATHAM PH.D. (OWNER)
(214) 207-5664
Entity
Organization

Contact information

Practice address
1626 W HIGHWAY 287 BUSINESS, SUITE #104, WAXAHACHIE, TX 75165-4712
(888) 935-0027
Mailing address
PO BOX 190408, DALLAS, TX 75219-0408
(214) 207-5664

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
11300
TX
103TC0700X
Clinical Psychologist
Primary
22513
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
081432901
TX
05
095323401
TX
05
098373601
TX
Enumeration date
10/05/2007
Last updated
06/13/2008
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