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General NPI Number Information
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NPI Number | 1871865030
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Entity Type | Organization
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Legal Business Name | EAST TEXAS COUNSELING & FAMILY THERAPY
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 1042 N PACIFIC ST
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City | MINEOLA
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State | TX
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Zip | 75773-1838
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Country | US
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Telephone | 903-262-6267
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Fax |
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Provider Business Mailing Address
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Address Line | 1042 N PACIFIC ST
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City | MINEOLA
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State | TX
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Zip | 75773-1838
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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 | COUNSELOR
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Name | ALICIA HOPPS
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Credential | MA, LPC
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Telephone | 903-262-6267
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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 | 66243
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License Number State | TX
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