Individual
BRENDA LEE GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCDC
Contact information
Practice address
1209 PARKWAY, AUSTIN, TX 78703-4132
(310) 497-6176
Mailing address
8007 W GATE BLVD, UNIT A, AUSTIN, TX 78745-6819
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11589
TX
1041C0700X
Clinical Social Worker
Primary
55232
TX
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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