Individual
VIVIAN RENEE DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E BURNETT ST, #44, ENNIS, TX 75119-6125
(972) 875-7015
Mailing address
1000 E BURNETT ST APT 44, ENNIS, TX 75119-6130
(972) 875-7015
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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