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Individual

MISS IRIS ELIZABETH HACKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
110 N. IH 35, 315 PMB 182, ROUND ROCK, TX 78681
(512) 587-7440
(512) 218-4150
Mailing address
110 N I H 35, 315 PMB 182, ROUND ROCK, TX 78681-5003
(512) 587-7440
(512) 218-4150

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
16566
TX
101YP2500X
Professional Counselor
16566
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137954
SUPERIOR
TX
01
542851
VALUE OPTIONS
TX
Enumeration date
01/08/2007
Last updated
07/19/2007
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