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Individual

MRS. CAROLYN W SIDEREAS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2237 RIDGE RD, STE 101, ROCKWALL, TX 75087-5164
(972) 771-3969
(972) 771-8258
Mailing address
2237 RIDGE RD, STE 101, ROCKWALL, TX 75087-5164
(972) 771-3969
(972) 771-8258

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17879
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17879
LPC LICENSE#
TX
Enumeration date
09/06/2005
Last updated
07/08/2007
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