Individual
KELLY JEAN AGUIRRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
502 N CARVER ST, MIDLAND, TX 79701-3634
(432) 570-3390
(432) 570-3375
Mailing address
502 N CARVER ST, MIDLAND, TX 79701-3634
(432) 570-3390
(432) 570-3375
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10721
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213673100
—
TX
Enumeration date
11/06/2013
Last updated
11/06/2013
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