Individual
MS. ANNA SUSAN GJERTSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
304 S 22ND ST, TEMPLE, TX 76501-4726
(254) 298-7042
Mailing address
1908 ANTELOPE TRL, HARKER HEIGHTS, TX 76548-2135
(254) 698-1556
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
15787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82659L
BC/BS PROVIDER NUMBER
TX
Enumeration date
03/25/2006
Last updated
07/09/2007
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