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Organization

COUNSELING AND DIAGNOSTIC CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUSAN TALMAGE PHD (EXECUTIVE DIRECTOR)
(214) 760-1964
Entity
Organization

Contact information

Practice address
16415 ADDISON RD, SUITE 640, ADDISON, TX 75001-3218
(214) 760-1964
(214) 760-9505
Mailing address
16415 ADDISON RD, SUITE 640, ADDISON, TX 75001-3218
(214) 760-1964
(214) 760-9505

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
64837
TX
103TS0200X
School Psychologist
34150
TX

Other

Enumeration date
06/05/2014
Last updated
06/05/2014
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