Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 66181 | TX |
NPI | 1003187774 |
---|---|
Provider Name | Laura L Brown |
First Address | San Antonio, TX 78201-5159 |
Second Address | San Antonio, TX 78201-5159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2012 |
Last Update Date | 26/01/2012 |