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General NPI Number Information
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NPI Number | 1104365972
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Entity Type | Organization
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Legal Business Name | COUNSELING ASSOCIATES OF CENTRAL TEXAS
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 1711 E CENTRAL TEXAS EXPY STE 100A
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City | KILLEEN
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State | TX
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Zip | 76541-9145
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Country | US
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Telephone | 254-501-3745
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Fax | 254-501-3608
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Provider Business Mailing Address
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Address Line | 2503 SCHULZE DR
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City | KILLEEN
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State | TX
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Zip | 76549-8565
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Country | US
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Telephone | 254-501-3745
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Fax | 254-501-3608
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Authorized Official
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Title or Position | MEMBER
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Name | AMY-JO C NEUJAHR
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Credential |
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Telephone | 254-501-3745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 200952
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License Number State | TX
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