Provider Information for 1982344461
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TIMOTHY SHREVE LCSW
Sex: Male
NPI: 1982344461
Last Updated: 2022-03-31
Certification Date: 2022-03-31
Certification Date: 2022-03-31
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1982344461 | ||||||||
| Enumeration Date | 2022-03-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 821 CREEKRIDGE DR DALLAS, TX 75218-2206 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 821 CREEKRIDGE DR DALLAS, TX 75218-2206 United States Phone: 972-816-7373 | Fax: | ||||||||
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