Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 63378 | TX |
NPI | 1003169384 |
---|---|
Provider Name | Laura Violeta Duenas-Guerrero |
First Address | Austin, TX 78726-1932 |
Second Address | Austin, TX 78746-6900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2012 |
Last Update Date | 24/10/2012 |