Doctor Name: | LISA R. COUCH |
NPI Number: | 1588964845 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 64555 |
Business Practice Address: | 300 E Broad St Forney, TX - 751269164 |
Business Phone Number: | 2146759483 |
Business Fax Number: | 2146759483 |
Mailing Address: | Po Box 3201, FORNEY |
State: | TX |
Postal Code: | 751263201 |
Phone Number: | 2146759483 |
Fax Number: | 2146759483 |
NPI Enumeration Date: | 11/02/2010 |
NPI Last Update Date: | 11/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 64555 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |