Doctor Name: | MRS. STACEY LYNN ECORD |
NPI Number: | 1477651511 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 14368 |
Business Practice Address: | 3926 Bahler Ave Manuel, TX - 77578 |
Business Phone Number: | 2814891290 |
Business Fax Number: | 2814898806 |
Mailing Address: | 3926 Bahler Ave, MANUEL |
State: | TX |
Postal Code: | 77578 |
Phone Number: | 2814891290 |
Fax Number: | 2814898806 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 14368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |