Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 60745 | TX |
NPI | 1003063124 |
---|---|
Provider Name | Jeanene R Poston |
First Address | Breckenridge, TX 76424-3538 |
Second Address | Breckenridge, TX 76424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2008 |
Last Update Date | 02/03/2018 |