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General NPI Number Information
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NPI Number | 1194312322
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Entity Type | Organization
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Legal Business Name | FOUR CORNERS COUNSELING, PLLC
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 1519 FLORENCE RD STE 14
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City | KILLEEN
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State | TX
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Zip | 76541-7903
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Country | US
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Telephone | 254-368-0633
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Fax | 254-294-2223
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Provider Business Mailing Address
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Address Line | PO BOX 690642
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City | KILLEEN
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State | TX
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Zip | 76549-0011
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Country | US
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Telephone | 254-368-0633
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | MS. ANGELIA HALL
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Credential | LPC
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Telephone | 254-368-0633
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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 |
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License Number State |
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