Individual
CANDIS JAI LAVALLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, LPC
Contact information
Practice address
6714 KESWICK DR, DALLAS, TX 75232-3315
(317) 435-7184
Mailing address
6714 KESWICK DR, DALLAS, TX 75232-3315
(317) 435-7184
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39004495A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92586
TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL
TX
Enumeration date
04/27/2023
Last updated
10/30/2023
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