Individual
SANDRA SHOULDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1180 OLD REDWATER RD, TEXARKANA, TX 75501-2253
(903) 276-9242
Mailing address
1180 OLD REDWATER RD, TEXARKANA, TX 75501-2253
(903) 276-9242
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
64428
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
4844
TX
Other
Enumeration date
04/16/2009
Last updated
03/11/2011
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