Individual
IAN BIRDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1003 JUSTIN LN, #2096, AUSTIN, TX 78757-2662
(512) 585-2304
Mailing address
1003 JUSTIN LN, #2096, AUSTIN, TX 78757-2662
(512) 585-2304
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
65478
TX
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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