Doctor Name: | MS. LORIE MARIE STOVALL |
NPI Number: | 1174964944 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | 65546 |
Business Practice Address: | 800 N Main St Corsicana, TX - 751103031 |
Business Phone Number: | 9036542407 |
Business Fax Number: | |
Mailing Address: | 1906 E Beverly Dr, CORSICANA |
State: | TX |
Postal Code: | 751102008 |
Phone Number: | 9038742403 |
Fax Number: | |
NPI Enumeration Date: | 07/09/2013 |
NPI Last Update Date: | 07/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 65546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |