Individual
MS. CHARLENE FRANCES WITTENEBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPA LPC MA MS NCC
Contact information
Practice address
1106 S MAYS ST, ROUND ROCK, TX 78664-6783
(410) 972-1384
Mailing address
3664 ROSALINA LOOP, ROUND ROCK, TX 78665-5681
(410) 972-1384
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
75941
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75941
INDIVIDUAL
TX
Enumeration date
07/24/2019
Last updated
07/24/2019
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