NPI age
19 years
Enumerated 2006-09-14
Across 3770 active counselor providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 13842 | LICENSE |
| 05 (TX) | 028480401 | |
| 01 (TX) | 4179LC | BCBS |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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