Provider Demographics
NPI:1467934026
Name:YEOMAN, MAURIE DARLENE (LPC)
Entity Type:Individual
Prefix:
First Name:MAURIE
Middle Name:DARLENE
Last Name:YEOMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 EVERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-8408
Mailing Address - Country:US
Mailing Address - Phone:817-846-7306
Mailing Address - Fax:
Practice Address - Street 1:6208 W POLY WEBB RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4324
Practice Address - Country:US
Practice Address - Phone:817-245-0769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health