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General NPI Number Information
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NPI Number | 1003124801
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Entity Type | Individual
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Provider Name | TRINA K BLUFORD ITA LPC
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Gender | Female
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 910 E CESAR CHAVEZ ST
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City | AUSTIN
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State | TX
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Zip | 78702-4206
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Country | US
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Telephone | 888-823-9194
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Fax | 888-708-9413
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Provider Business Mailing Address
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Address Line | 9009 N FM 620 APT 1815
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City | AUSTIN
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State | TX
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Zip | 78726-4224
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Country | US
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Telephone | 512-293-7985
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Fax | 888-708-9413
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 65441
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 65441
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License Number State | TX
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