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1801405238
CAMERON FOUNTAIN
IRVING, TX
NPI
1801405238
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-07-31
Last Update Date
2020-07-31
Business Address
CAMERON FOUNTAIN LCDC
612 N STORY RD STE 101
IRVING, TX 75061-6764
Phone number: 469-708-2955
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Mailing Address
CAMERON FOUNTAIN LCDC
8109 SKILLMAN ST APT 3008
DALLAS, TX 75231-2828
Phone number:
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