Individual
AUSTYN TEAL BAILIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1058 ASHER WAY STE 400, TYLER, TX 75703-6076
(903) 952-3757
Mailing address
1058 ASHER WAY STE 400, TYLER, TX 75703-6076
(903) 952-3757
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
78113
TX
Other
Enumeration date
07/19/2020
Last updated
07/19/2020
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