Individual
GUSTAVO ALEXIS MURILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, MS, LCDC
Contact information
Practice address
1245 DELMITA DR, FORNEY, TX 75126-3560
(469) 618-1189
Mailing address
1245 DELMITA DR, FORNEY, TX 75126-3560
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16302
TX
Other
Enumeration date
02/21/2023
Last updated
06/18/2024
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