Individual
MRS. MARY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6733 CAMP BOWIE BLVD, FT WORTH, TX 76116-7112
(817) 386-9180
(817) 386-9138
Mailing address
6009 ED COADY RD, FORT WORTH, TX 76134-2502
(817) 228-0399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TX
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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