NPI age
20 years
Enumerated 2005-09-14
Across 3770 active counselor providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 2948LC | BCBS PROVIDER ID |
| 01 (TX) | LPC 12902 | TEXAS STATE LICENSE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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