Individual
MRS. LESHAUNNE CHARISE COXUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3212 COLLINSWORTH ST STE 22, FORT WORTH, TX 76107-6507
(817) 829-4749
Mailing address
PO BOX 16071, FORT WORTH, TX 76162-0071
(817) 829-4749
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
63906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12746100044000
DARS VID#
TX
05
—
284676801
—
TX
01
—
284676802
MEDICAID CSHCN
TX
Enumeration date
01/21/2011
Last updated
10/02/2012
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