Doctor Name: | MRS. CARLA FALCON CHEATHAM |
NPI Number: | 1487985511 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 64209 |
Business Practice Address: | 144 Oak Park Rd Adkins, TX - 781012401 |
Business Phone Number: | 2107771679 |
Business Fax Number: | |
Mailing Address: | 144 Oak Park Road, ADKINS |
State: | TX |
Postal Code: | 781012401 |
Phone Number: | 2107771679 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2010 |
NPI Last Update Date: | 08/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 64209 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |