Doctor Name: | TERRY T AULTMAN |
NPI Number: | 1013121805 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA LPC |
License Number: | 61145 |
Business Practice Address: | 6236 N Highway 146 Suite 9 Baytown, TX - 775239081 |
Business Phone Number: | 2819180152 |
Business Fax Number: | 2819180151 |
Mailing Address: | 6236 N Highway 146, Suite 9 BAYTOWN |
State: | TX |
Postal Code: | 775239081 |
Phone Number: | 2819180152 |
Fax Number: | 2819180151 |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 61145 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |