Individual
ANDREW DUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LCDC
Contact information
Practice address
4316 BILGLADE RD, FORT WORTH, TX 76109-5317
(217) 417-1059
Mailing address
4316 BILGLADE RD, FORT WORTH, TX 76109-5317
(217) 417-1059
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
72717
TX
3245S0500X
Children's Substance Abuse Rehabilitation Facility
11953
TX
Other
Enumeration date
07/17/2014
Last updated
06/05/2020
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