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Provider Information for 1952620072


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PETRA MANN LPC


Sex: Female

NPI: 1952620072
Last Updated: 2011-05-05
Certification Date:

Details

NameValue
NPI1952620072
Enumeration Date2010-05-28
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 700 ROGERS ST
SAN MARCOS, TX 78666-3228
United States

Phone: 832-276-2847 | Fax:512-392-1584
 
Primary Practice Address 700 ROGERS ST
SAN MARCOS, TX 78666-3228
United States

Phone: 832-276-2847 | Fax:512-392-1584
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101Y00000X - Counselor TX63646