Organization
CENTRAL METHODIST UNIVERSITY
Active
Other names
CMU Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
(972) 367-4845
Entity
Organization
Contact information
Practice address
411 CENTRAL METHODIST SQ, RM 206, FAYETTE, MO 65248-1104
(972) 367-4845
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2005041421
MS
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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