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General NPI Number Information
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NPI Number | 1952713935
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Entity Type | Individual
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Provider Name | DONNA LEE TENELLY LPC-S; LPC-INTERN
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Gender | Female
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 612 S GRAY ST
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City | KILLEEN
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State | TX
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Zip | 76541-7140
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Country | US
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Telephone | 254-702-3452
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Fax |
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Provider Business Mailing Address
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Address Line | 975 SEVEN RANCH RD
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City | SALADO
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State | TX
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Zip | 76571-5189
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Country | US
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Telephone | 254-681-5441
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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 | 61197
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License Number State | TX
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