Organization
BRANCH OF LIFE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILLY W CORN LPC,LMFT (CEO)
(972) 296-2676
Entity
Organization
Contact information
Practice address
202 W CENTER ST STE F, DUNCANVILLE, TX 75116-3441
(972) 296-2676
Mailing address
8554 COUNTY ROAD 4023, KEMP, TX 75143-4354
(972) 296-2676
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187018001
—
TX
Enumeration date
02/23/2011
Last updated
02/23/2011
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