MEDICARE: KATHERINE ANN GIDDENS 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	101YM0800X	Mental Health Counselor	78051	TX

General Provider Information

NPI Number	:	1508427873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ANN GIDDENS LPC

Provider Business Mailing Address
First Line	:	4245 CENTERGATE ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4802
Country	:	US
Telephone Number	:	210-422-2915
Fax Number	:

Provider Business Practice Location Address
First Line	:	4245 CENTERGATE ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4802
Country	:	US
Telephone Number	:	210-422-2915
Fax Number	:

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

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	06/26/2019

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Directions to “ KATHERINE ANN GIDDENS LPC” Practice Location

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