Individual
MR. GARY LEE MADDUX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC-A
Contact information
Practice address
9153 BELSHIRE DR STE 130, NORTH RICHLAND HILLS, TX 76182-7643
(214) 865-9598
Mailing address
2341 RAVENWOOD DR, KELLER, TX 76262-8030
(540) 842-8394
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
91610
TX
101YM0800X
Mental Health Counselor
Primary
91610
TX
101YP2500X
Professional Counselor
91610
TX
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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