Individual provider · Type 1 NPI
Mary Dybala, LCDC
Addiction (Substance Use Disorder) Counselor · Fort Worth, TX
NPI number
1083052005
Active
Practice location
3840 Hulen St, Htn, Client Accounting
Fort Worth, TX 76107-7277
Mailing address
PO Box 2603, Htn, Client Accounting
Fort Worth, TX 76113-2603
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 6818 (TX) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1083052005
Mary Dybala, LCDC's National Provider Identifier is 1083052005, issued on Jun 12, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fort Worth, TX. The record was last updated on Nov 18, 2013.