Individual
HALLIE BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC ASSOCIATE
Contact information
Practice address
3017 ELM RIVER DR, FORT WORTH, TX 76116-0697
(817) 996-8761
Mailing address
3017 ELM RIVER DR, FORT WORTH, TX 76116-0697
(817) 996-8761
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
93213
TX
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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