Provider Demographics
NPI:1881455442
Name:MARRIAGE THERAPY FOR MEDICAL PROFESSIONALS PLLC
Entity type:Organization
Organization Name:MARRIAGE THERAPY FOR MEDICAL PROFESSIONALS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ-FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:469-645-0145
Mailing Address - Street 1:2221 JUSTIN RD # 119-264
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-4848
Mailing Address - Country:US
Mailing Address - Phone:469-645-0145
Mailing Address - Fax:
Practice Address - Street 1:216 LAKELAND DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-6914
Practice Address - Country:US
Practice Address - Phone:469-645-0145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty