Provider Demographics
NPI:1003128158
Name:HEAD, EMILY DIANNE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:DIANNE
Last Name:HEAD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 FM 2181
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-7646
Mailing Address - Country:US
Mailing Address - Phone:214-535-4824
Mailing Address - Fax:
Practice Address - Street 1:3630 FM 2181
Practice Address - Street 2:SUITE 101
Practice Address - City:HICKORY CREEK
Practice Address - State:TX
Practice Address - Zip Code:75065-7646
Practice Address - Country:US
Practice Address - Phone:214-535-4824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional