Individual
CLAUDIA P SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
210 E PEARL ST, GRANBURY, TX 76048-2211
(817) 573-6922
(817) 579-6611
Mailing address
PO BOX 758, GRANBURY, TX 76048-0758
(817) 573-6922
(817) 579-6611
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
13881
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027764201
—
TX
Enumeration date
10/28/2008
Last updated
10/28/2008
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