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Individual

DR. JOSEPH MARK DEYOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
4928 PARK BROOK DR, FORT WORTH, TX 76137-5412
(817) 988-8242
Mailing address
4928 PARK BROOK DR, FORT WORTH, TX 76137-5412
(817) 988-8242

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4796
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028434101
TX
Enumeration date
09/29/2010
Last updated
09/29/2010
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