Individual
MRS. GAIL KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1614 AVENUE K, LUBBOCK, TX 79401-5042
(806) 763-7633
(806) 765-0130
Mailing address
1614 AVENUE K, LUBBOCK, TX 79401
(806) 763-7633
(806) 765-0130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
07502070
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065363601
—
TX
Enumeration date
09/14/2009
Last updated
09/14/2009
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