Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 78228 | TX |
NPI | 1003427634 |
---|---|
Provider Name | Casheba Christopher |
First Address | Terrell, TX 75160-0014 |
Second Address | Terrell, TX 75160-4302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2020 |
Last Update Date | 17/08/2020 |