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General NPI Number Information
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NPI Number | 1215538699
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Entity Type | Individual
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Provider Name | KAREN RAY ROZELL
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 5301 ALPHA RD
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City | DALLAS
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State | TX
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Zip | 75240-4355
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Country | US
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Telephone | 972-345-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 5910 ROMA DR APT 21
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City | SHREVEPORT
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State | LA
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Zip | 71105-4263
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Country | US
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Telephone | 972-345-5650
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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 | 17642
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License Number State | TX
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