Waddell, Tarsyia Melissa
Waddell, Tarsyia Melissa is an sole proprietor health care provider with primary practice located at 900 E Park Blvd Suite 155, Plano TX 75074-5465. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Waddell, Tarsyia Melissa can be contacted via phone (214) 738-6869.Contact Information
Primary practice address
900 E Park Blvd Suite 155
Plano TX 75074-5465
Phone: (214) 738-6869
Fax: (402) 233-3466
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 7317 | Texas |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 16012 | Texas |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 180002879 | Illinois |
Profile Details
NPI number | 1225189764 |
---|---|
LBN Legal business name | Waddell, Tarsyia Melissa |
Credentials | LPC.LCDC.CEAP.SAP. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 12th, 2007 |
Last updated | Jun 27th, 2011 - about 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1225189764 | NPPES |
Texas | MEDICAID | 156099701 |
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