Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 60678 | TX |
N | 225C00000X | Rehabilitation Counselor | 00056671 | TX |
NPI | 1184889149 |
---|---|
Provider Name | Ms. Iris L Kuykendall |
First Address | Burleson, TX 76028-4960 |
Second Address | Burleson, TX 76028-4960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 10/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
600607151 | BCBSTX (01) | TX |