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1992207856
DETRAE EUGENE WARREN
FORT WORTH, TX
NPI
1992207856
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TX 68544)
Enumeration Date
2018-03-06
Last Update Date
2018-03-06
Business Address
DETRAE EUGENE WARREN LPC
1307 8TH AVE STE 310
FORT WORTH, TX 76104-4140
Phone number: 817-851-2042
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Mailing Address
DETRAE EUGENE WARREN LPC
3704 GRIGGS AVE
FORT WORTH, TX 76119-2018
Phone number: 817-565-6417
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