Individual
LYDIA HAUREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MHSP
Contact information
Practice address
1201 N WILCOX DR STE C, KINGSPORT, TN 37660-4986
(423) 225-3757
Mailing address
1709 MIAMI DR, JOHNSON CITY, TN 37601-7542
(765) 413-0627
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5834
TN
Other
Enumeration date
03/17/2022
Last updated
10/10/2023
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