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1500 Industrial Blvd Ste 306 Abilene TX 79602-7601 | |
| (325) 518-4652 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1500 Industrial Blvd Ste 306, Abilene, Texas |
| Authorized Official Name and Position | Susan Stuckey (OWNER) |
| Authorized Official Contact | 3255184652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1500 Industrial Blvd Ste 306 Abilene TX 79602-7601 Ph: (325) 518-4652 | 1500 Industrial Blvd Ste 306 Abilene TX 79602-7601 Ph: (325) 518-4652 |
| NPI Number | 1104686104 |
|---|---|
| Provider Enumeration Date | 03/19/2024 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104686104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
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