Organization
BREAKTHROUGH THERAPY OF FRISCO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON WATERS-BLAND (OWNER)
(817) 894-1122
Entity
Organization
Contact information
Practice address
2770 MAIN ST, SUITE 125, FRISCO, TX 75033-4302
(469) 777-8448
Mailing address
2770 MAIN ST, SUITE 125, FRISCO, TX 75033-4302
(469) 777-8448
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
61178
TX
1041C0700X
Clinical Social Worker
Primary
53730
TX
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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