Individual
CHRISTINA SUSAN DELOACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC
Contact information
Practice address
1615 SIOUX TRL, KINGSLAND, TX 78639-9636
(254) 630-6169
Mailing address
1615 SIOUX TRL, KINGSLAND, TX 78639-9636
(254) 630-6169
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
82495
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82495
TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS LPC
TX
Enumeration date
11/01/2021
Last updated
11/01/2021
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