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Individual
LYDIA BUSSELL
Active
Individual
LYDIA BUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
85428
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85428
LICENSE
TX
01
—
TEXAS
LICENSE
—
Enumeration date
11/29/2021
Last updated
11/29/2021
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