Individual
AILEEN DEVEREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
605 SHADY LANE N, KELLER, TX 76248
(817) 522-6622
(817) 379-1933
Mailing address
605 SHADY LANE N, KELLER, TX 76248
(817) 522-6622
(817) 379-1933
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
41287
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2879785-02
—
TX
05
—
2879785-03
—
TX
05
—
287978504
—
TX
Enumeration date
08/26/2008
Last updated
08/27/2024
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