Provider Demographics
NPI:1720598576
Name:DALLAS THERAPY COLLECTIVE, PLLC
Entity Type:Organization
Organization Name:DALLAS THERAPY COLLECTIVE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-879-6051
Mailing Address - Street 1:3340 LEAHY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-3852
Mailing Address - Country:US
Mailing Address - Phone:479-879-6051
Mailing Address - Fax:
Practice Address - Street 1:8140 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4350
Practice Address - Country:US
Practice Address - Phone:479-879-6051
Practice Address - Fax:479-879-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty