Individual
MRS. AMY ABBASOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. LPC-S
Contact information
Practice address
23 BESEMER LN, ITHACA, NY 14850-9699
(806) 236-4156
Mailing address
23 BESEMER LN, ITHACA, NY 14850-9699
(806) 236-4156
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
65000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65000
TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS
TX
Enumeration date
10/04/2019
Last updated
05/04/2023
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