Individual
MR. ALFRED BERNARD WISHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LCDC, MAC, CRC
Contact information
Practice address
5507 REIGER AVE, DALLAS, TX 75214-5041
(214) 923-5093
Mailing address
5507 REIGER AVE, DALLAS, TX 75214-5041
(214) 923-5093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12537
TX
101YM0800X
Mental Health Counselor
71266
TX
101YP2500X
Professional Counselor
Primary
71266
TX
Other
Enumeration date
06/13/2015
Last updated
11/10/2016
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