is a Counselor in , . practices all healthcare services and medical treatments related to Counselor. The NPI Number for is 1881744019. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | , , |
| Phone Number | |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1881744019 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
|---|---|
| City | |
| State | () |
| Post Code | |
| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
| Licence No | 13188 |
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Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 26970602 | TX | -- | |
| 115530100 | COMPCARE | ||
| 26970601 | TX | -- | |
| 3275LC | BCBS | ||
| 26970604 | TX | -- | |
| 200271770 A | OK | -- | |
| 771199 | AETNA | ||
| 3230384 | NM | -- | |
| 26970605 | TX | -- |
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