Individual
AMANDA CHISM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1219 DALLAS ST, PORT NECHES, TX 77651-2908
(409) 234-5776
Mailing address
3145 AVENUE H, NEDERLAND, TX 77627-7609
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
83492
TX
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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