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Individual

MR. DALE EDMIASTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT, LCSW, LCDC

Contact information

Practice address
5606 HONDO DRIVE, GRANBURY, TX 76049
(817) 326-4081
(817) 326-3495
Mailing address
PO BOX 711, GRANBURY, TX 76048-0711
(817) 326-4081
(817) 326-3495

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3058
TX
104100000X
Social Worker
Primary
10202
TX
1041C0700X
Clinical Social Worker
10202
TX
106H00000X
Marriage & Family Therapist
TX

Other

Enumeration date
12/28/2006
Last updated
09/11/2025
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