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Individual

SARA ELIZABETH DESHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1901 DUTTON DR, SUITE E, SAN MARCOS, TX 78666-7573
(512) 396-7695
(512) 396-7633
Mailing address
1901 DUTTON DR, SUITE E, SAN MARCOS, TX 78666-7573
(512) 396-7695
(512) 396-7633

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
67965
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12149
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
065337001
TX
Enumeration date
07/02/2013
Last updated
07/02/2013
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