Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 80781 | TX |
N | 101YM0800X | Mental Health Counselor | 80781 | TX |
N | 101YP2500X | Professional Counselor | 80781 | TX |
N | 101YS0200X | School Counselor | 80781 | TX |
NPI | 1235764101 |
---|---|
Provider Name | Mrs. Brenda Lee Kyger-Skidgel |
First Address | Porter, TX 77365 |
Second Address | Porter, TX 77365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2020 |
Last Update Date | 11/03/2020 |