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General NPI Number Information
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NPI Number | 1114788700
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Entity Type | Individual
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Provider Name | CRYSTAL ALANE GOODWIN OEHLERS LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 142 OLD TOWN BLVD N STE 200
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City | LANTANA
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State | TX
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Zip | 76226-3990
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Country | US
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Telephone | 940-294-7061
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Fax |
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Provider Business Mailing Address
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Address Line | 600 PARTRIDGE DR
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City | ARGYLE
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State | TX
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Zip | 76226-5118
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Country | US
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Telephone | 423-948-2618
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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 | 93867
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License Number State | TX
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