Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 12078 | TX |
NPI | 1003061151 |
---|---|
Provider Name | Dr. Cathey Soutter |
First Address | Dallas, TX 75206-5626 |
Second Address | Dallas, TX 75252-5654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2008 |
Last Update Date | 17/11/2008 |