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General NPI Number Information
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NPI Number | 1114556578
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Entity Type | Individual
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Provider Name | KRISTINA LUERA LPC, LSOTP
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Gender | Female
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 12/17/2022
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Provider Practice Location Address
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Address Line | 5646 AVENUE A
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City | LUBBOCK
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State | TX
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Zip | 79404-4530
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Country | US
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Telephone | 806-775-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 50TH ST STE 209
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City | LUBBOCK
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State | TX
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Zip | 79414-3515
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Country | US
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Telephone | 806-809-4661
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 77728
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License Number State | TX
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