NPI 1750822805

Mark Stalls, CPED

Practitioner Prevention Professional Denton, TX

Practice location

Address: 3106 Santa Monica Dr, Denton, TX 76205-8522
Phone: (940) 367-0641
Fax: (940) 383-4144

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence ABC CPED 1094 (TX)

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Registry record

NPI: 1750822805
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Mar 2017
Record last updated: 8 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.