Organization
FAMILY DYNAMICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN DURHAM LCSW-ACP, LMFT (PRESIDENT)
(972) 404-8253
Entity
Organization
Contact information
Practice address
12850 HILLCREST RD, SUITE F-206, DALLAS, TX 75230-1529
(972) 404-8253
(972) 701-0874
Mailing address
12850 HILLCREST RD, SUITE F-206, DALLAS, TX 75230-1529
(972) 404-8253
(972) 701-0874
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2443
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06MR
BCBS
TX
Enumeration date
09/23/2005
Last updated
09/29/2010
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