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General NPI Number Information
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NPI Number | 1417565110
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Entity Type | Individual
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Provider Name | RACHEL RENEE SPURGEON LPC
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Gender | Female
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 120 W 5TH ST STE 105
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City | TYLER
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State | TX
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Zip | 75701-4053
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Country | US
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Telephone | 903-201-7865
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Fax |
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Provider Business Mailing Address
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Address Line | 147 N MAIN ST
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City | YANTIS
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State | TX
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Zip | 75497-2727
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Country | US
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Telephone | 903-853-0144
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 78385
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License Number State | TX
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