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General NPI Number Information
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NPI Number | 1952953861
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Entity Type | Organization
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Legal Business Name | COURAGEOUS NEW DIRECTIONS, PLLC
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 202 W CENTRAL TEXAS EXPY STE 206
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City | KILLEEN
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State | TX
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Zip | 76541-8902
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Country | US
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Telephone | 254-392-0118
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Fax |
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Provider Business Mailing Address
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Address Line | 451D E CENTRAL TEXAS EXPY # 304
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-1962
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Country | US
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Telephone | 254-392-0118
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KAMI LEA DIAZ
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Credential | LCSW-S
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Telephone | 254-392-0118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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