Healthcare Provider Details

I. General information

NPI: 1124006093
Provider Name (Legal Business Name): KATREASE A. ESQUIVEL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 MORRISS RD SUITE 112
FLOWER MOUND TX
75028-3710
US

IV. Provider business mailing address

6021 MORRISS RD SUITE 112
FLOWER MOUND TX
75028-3710
US

V. Phone/Fax

Practice location:
  • Phone: 469-635-2200
  • Fax: 972-874-0523
Mailing address:
  • Phone: 469-635-2200
  • Fax: 972-874-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17254
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: