Individual
MAMIE LEANN FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 335-3022
Mailing address
PO BOX 2603, FORT WORTH, TX 76113-2603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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