Individual
MRS. CONNIE BRANNON KITCHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
409 N FREDONIA ST STE 105, LONGVIEW, TX 75601-6466
(903) 235-4779
(903) 753-0197
Mailing address
230 PINE CIR, HALLSVILLE, TX 75650-4555
(903) 235-4779
(903) 753-0197
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
15612
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4147LC
BCBS
TX
01
—
6307LC
BCBS
TX
Enumeration date
09/12/2006
Last updated
07/09/2007
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