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General NPI Number Information
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NPI Number | 1679083323
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Entity Type | Individual
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Provider Name | STEPHANIE WITWER LPC
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 10/09/2017
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Provider Practice Location Address
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Address Line | 10761 PEBBLE HILLS BLVD STE F
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City | EL PASO
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State | TX
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Zip | 79935-2037
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Country | US
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Telephone | 915-594-8685
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Fax | 866-232-4271
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Provider Business Mailing Address
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Address Line | PO BOX 1063
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City | SANTA TERESA
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State | NM
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Zip | 88008-1063
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Country | US
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Telephone |
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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 | 74512
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License Number State | TX
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