Doctor Name: | CATHERINE TITO |
NPI Number: | 1023495058 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. LPC INTERN |
License Number: | 73913 |
Business Practice Address: | 181 Grand Ave Suite 230 Southlake, TX - 760927631 |
Business Phone Number: | 8177561440 |
Business Fax Number: | |
Mailing Address: | 2777 Chatswood Dr, TROPHY CLUB |
State: | TX |
Postal Code: | 762623429 |
Phone Number: | 8173430015 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2015 |
NPI Last Update Date: | 04/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 73913 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |