Provider Demographics
NPI:1639820681
Name:WARREN, XAVBRYELLE AASHER
Entity Type:Individual
Prefix:DR
First Name:XAVBRYELLE
Middle Name:AASHER
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 N JUPITER RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2214
Mailing Address - Country:US
Mailing Address - Phone:901-921-2441
Mailing Address - Fax:
Practice Address - Street 1:3501 N JUPITER RD APT 2A
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2214
Practice Address - Country:US
Practice Address - Phone:901-921-2441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86693101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health