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General NPI Number Information
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NPI Number | 1659885671
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Entity Type | Individual
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Provider Name | MAURA CARMODY JARLDANE M.ED, LPC-S, NCC
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1700 N BIG SPRING ST
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City | MIDLAND
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State | TX
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Zip | 79701-2624
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Country | US
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Telephone | 432-682-7273
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Fax | 432-685-0108
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Provider Business Mailing Address
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Address Line | 4711 NEELY AVE
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City | MIDLAND
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State | TX
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Zip | 79707-5215
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Country | US
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Telephone | 432-894-0963
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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 | 63404
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License Number State | TX
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