Jacqueline Bentley, PHD, LMFT

Individual provider Active NPI Marriage & Family Therapist · Coppell, TX

NPI 1992153175 · NPPES record last updated May 29, 2016

Key facts

NPI
1992153175
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
201983 (TX)
Practice address
902 Mallard Dr
Coppell, TX 75019-5925
Phone
(214) 763-8191
NPI assigned
May 29, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
201983TXMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 201983 TX Yes

Addresses

Primary practice location

902 Mallard Dr
Coppell, TX 75019-5925

Mailing address

902 Mallard Dr
Coppell, TX 75019-5925
Phone (214) 763-8191

Other providers in Coppell, TX

All providers in Coppell, TX · Marriage & Family Therapist in Texas

Sources for this page

Verify at the official NPI Registry.