Individual
JUDY GAITHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1706 ENDERLY PLACE, FORT WORTH, TX 76104
(817) 614-6041
(817) 207-8088
Mailing address
1706 ENDERLY PL, FORT WORTH, TX 76104-4122
(817) 614-6041
(817) 207-8088
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
17111
TX
101YP2500X
Professional Counselor
17111
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157081402
—
TX
Enumeration date
09/26/2006
Last updated
09/27/2012
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