Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 64301 | TX |
Y | 101YM0800X | Mental Health Counselor | 64301 | TX |
N | 101YP1600X | Pastoral Counselor | 64301 | TX |
N | 101YP2500X | Professional Counselor | 64301 | TX |
NPI | 1326335878 |
---|---|
Provider Name | Ms. Chris E. Goetz |
First Address | Dallas, TX 75247-4914 |
Second Address | Dallas, TX 75216-4531 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2011 |
Last Update Date | 16/07/2012 |