Organization
JACY RADER LLC
Active
Other names
White Rock Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
JACY RADER LPC (THERAPIST)
(817) 880-4383
Entity
Organization
Contact information
Practice address
9026 GARLAND RD, DALLAS, TX 75218-3919
(817) 880-4383
Mailing address
2362 OLDBRIDGE DR, DALLAS, TX 75228-5360
(817) 880-4383
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
73765
TX
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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