Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 58139 | TX |
NPI | 1003201591 |
---|---|
Provider Name | Mrs. Nancy Herren |
First Address | Dallas, TX 75216-7167 |
Second Address | Dallas, TX 75236-2008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 01/04/2015 |