Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 16254 | TX |
N | 101YM0800X | Mental Health Counselor | 16254 | TX |
N | 101YP1600X | Pastoral Counselor | 16254 | TX |
Y | 101YP2500X | Professional Counselor | 16254 | TX |
NPI | 1043389802 |
---|---|
Provider Name | Debra J. Purvis |
First Address | Arlington, TX 76012-0095 |
Second Address | Bedford, TX 76021-5869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 07/12/2016 |