Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 69916 | TX |
Y | 101YM0800X | Mental Health Counselor | 69916 | TX |
N | 101YP2500X | Professional Counselor | 69916 | TX |
N | 101YS0200X | School Counselor |
NPI | 1053714634 |
---|---|
Provider Name | Mrs. Kimberley Buckner-Manley |
First Address | The Woodlands, TX 77381-6148 |
Second Address | Spring, TX 77380-3646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2014 |
Last Update Date | 26/02/2019 |