MEDICARE: LAILLAH GUICE LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	71448	TX

General Provider Information

NPI Number	:	1356882815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAILLAH GUICE LPC

Provider Business Mailing Address
First Line	:	640 ROOSTER RUN
Second Line	:
City	:	SCHERTZ
State	:	TX
Zip	:	78154-1840
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6363 DE ZAVALA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2103
Country	:	US
Telephone Number	:	210-399-4838
Fax Number	:	210-877-9279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2017
Last Update Date	:	03/16/2017

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Directions to “ LAILLAH GUICE LPC” Practice Location

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