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General NPI Number Information
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NPI Number | 1235119165
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Entity Type | Individual
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Provider Name | KRISTAL LUCILLE WOODBECK LPC
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 805 CORYELL
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City | LEAGUE CITY
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State | TX
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Zip | 77573
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Country | US
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Telephone | 281-309-4373
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Fax |
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Provider Business Mailing Address
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Address Line | 805 CORYELL
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City | LEAGUE CITY
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State | TX
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Zip | 77573
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Country | US
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Telephone | 281-332-8608
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Fax | 281-332-5283
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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 | 12626
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License Number State | TX
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