NPI age
19 years
Enumerated 2006-08-11
Across 23131 active counselor providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 4108103 | AETNA |
| 05 (TX) | 0257537-01 | |
| 01 (TX) | 760514412 | TAX IDENTIFICATION NUMBER |
| 01 (TX) | 83459L | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 35 other active providers share this practice address in NPPES.
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