Individual
COURTNEY WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
172 CREEKSIDE PARK RD, SPRING BRANCH, TX 78070-6109
(830) 261-3817
Mailing address
125 RANCH DR, BOERNE, TX 78015-8319
(210) 887-4552
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
79358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598237950
NPI
TX
Enumeration date
07/14/2020
Last updated
07/14/2020
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