NPI age
16 years
Enumerated 2009-08-10
Across 23131 active counselor providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 12285614 | CAQH |
| 01 (TX) | 10857 | LCDC |
| 01 (TX) | 65821 | STATE OF TEXAS |
| 05 (TX) | 2813990 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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