Doctor Name: | TRINA K BLUFORD ITA |
NPI Number: | 1003124801 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 65441 |
Business Practice Address: | 910 E Cesar Chavez St Austin, TX - 787024206 |
Business Phone Number: | 8888239194 |
Business Fax Number: | 8887089413 |
Mailing Address: | 9009 N Fm 620 Apt 1815, AUSTIN |
State: | TX |
Postal Code: | 787264224 |
Phone Number: | 5122937985 |
Fax Number: | 8887089413 |
NPI Enumeration Date: | 09/15/2010 |
NPI Last Update Date: | 09/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 65441 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |