Individual
MS. SUSAN J CARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, MA
Contact information
Practice address
2304 MIDWESTERN PARKWAY, SUITE 103A, WICHITA FALLS, TX 76308-2342
(940) 691-1267
(940) 691-1582
Mailing address
2304 MIDWESTERN PARKWAY, SUITE 103A, WICHITA FALLS, TX 76308-2342
(940) 691-1267
(940) 691-1582
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
19099
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168147001
—
TX
01
—
84473L
BLUE CROSS ID NUMBER
TX
Enumeration date
02/20/2007
Last updated
07/23/2009
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