Healthcare Provider Details
I. General information
NPI: 1548039795
Provider Name (Legal Business Name): KAMIA STINSON ESQUERRA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/29/2023
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4204 MILDRED AVE
KILLEEN TX
76549-3751
US
IV. Provider business mailing address
4204 MILDRED AVE
KILLEEN TX
76549-3751
US
V. Phone/Fax
- Phone: 254-338-8937
- Fax:
- Phone: 512-540-4035
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 70370 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: