Eagle, Mary Madison

Eagle, Mary Madison is an sole proprietor health care provider with primary practice located at 4837 Bryce Ave , Fort Worth TX 76107-4144. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Eagle, Mary Madison can be contacted via phone (817) 980-7474.

Contact Information

Primary practice address
4837 Bryce Ave Fort Worth TX 76107-4144
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 16-18P Arkansas

Profile Details

NPI number 1639625171
LBN Legal business name Eagle, Mary Madison
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 25th, 2016
Last updated Aug 25th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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