Individual
MARISSA ANN CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 STATE PARK RD STE 109, LOCKHART, TX 78644-3832
(512) 537-5797
Mailing address
430 FARMERS RD, MAXWELL, TX 78656-4283
(512) 557-3537
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
105196
TX
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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