Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 842 | AK |
NPI | 1003059924 |
---|---|
Provider Name | Ms. D. Charlene Hackett |
First Address | Corpus Christi, TX 78414-3767 |
Second Address | Corpus Christi, TX 78414-3767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 18/08/2015 |