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Organization
MINDFUL LIFE COUNSELING CENTER PLLC
Active
Organization
MINDFUL LIFE COUNSELING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY ANN HICKS M.S. ED, LCPC, LDN (PSYCHOTHERAPIST)
(815) 751-7700
Entity
Organization
Contact information
Practice address
15632 ST HWY 110 S, SUITE 26, WHITEHOUSE, TX 75791-9384
(815) 751-7700
(190) 329-7699
Mailing address
15632 HWY 110 S., SUITE 26, WHITEWATER, TX 75791
(815) 751-7700
(190) 329-7699
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
76385
TX
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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