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NPI 1629383385

NPI 1629383385 : MAGON KUNES LPC : GEORGETOWN, TX

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General NPI Number Information
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    NPI Number           |    1629383385
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    Entity Type          |    Individual 
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    Provider Name        |    MAGON KUNES LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/18/2010
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    Last Update Date     |    06/01/2016
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Provider Practice Location Address
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    Address Line         |    3008 DAWN DR SUITE 101
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    City                 |    GEORGETOWN
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    State                |    TX
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    Zip                  |    78628-2821
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    Country              |    US
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    Telephone            |    603-724-0079
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    180 EAGLE OWL LOOP 
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    City                 |    LEANDER
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    State                |    TX
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    Zip                  |    78641-2712
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    Country              |    US
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    Telephone            |    603-724-0079
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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       |    73209
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    License Number State |    TX
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