Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 80659 | TX |
N | 225XL0004X | Low Vision | LPC |
NPI | 1164047098 |
---|---|
Provider Name | Miss Asha Hussein |
First Address | San Angelo, TX 76901-5286 |
Second Address | Round Rock, TX 78665-3928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2020 |
Last Update Date | 10/12/2020 |