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General NPI Number Information
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NPI Number | 1508874629
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Entity Type | Individual
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Provider Name | TRISHA BOWEN KERR LPC, RN, CNS PMH,CEA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 14729 HIGHWAY 105 W SUITE 180
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City | MONTGOMERY
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State | TX
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Zip | 77356-6025
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Country | US
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Telephone | 936-588-6122
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Fax | 936-588-6124
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Provider Business Mailing Address
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Address Line | 105 LULLABYE LN
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City | MONTGOMERY
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State | TX
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Zip | 77356-8875
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Country | US
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Telephone | 936-588-6122
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Fax | 936-588-6124
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12649
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License Number State | TX
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