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Individual
STEFANI THREADGILL
Active
Individual
STEFANI THREADGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT-A, LPC-I, LCDC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
73688
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
12920
TX
106H00000X
Marriage & Family Therapist
Primary
202441
TX
Other
Enumeration date
09/01/2015
Last updated
12/02/2016
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