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NPI Code Detail

MEDICARE: KAILA SUE RICE LPCI

MEDICARE: KAILA SUE RICE LPCI
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
1101YM0800XMental Health Counselor71737TX

General Provider Information

NPI Number : 1467835090
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILA SUE RICE LPCI
Provider Business Mailing Address
First Line : 1011 COLLEGE AVE
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-3307
Country : US
Telephone Number : 903-589-9000
Fax Number : 903-589-3443
Provider Business Practice Location Address
First Line : 1011 COLLEGE AVE
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-3307
Country : US
Telephone Number : 903-589-9000
Fax Number : 903-589-3443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2015
Last Update Date : 07/01/2015

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