Individual
ANGELIQUECA AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8700 9TH AVE STE 106, PORT ARTHUR, TX 77642-8069
(409) 729-8805
Mailing address
1009 WESTMEADOW DR, BEAUMONT, TX 77706-3876
(409) 656-7755
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
60868
TX
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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