Individual
KAREN WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1510 S VINE AVE, TYLER, TX 75701-2826
(903) 526-4055
Mailing address
PO BOX 1764, LINDALE, TX 75771-1764
(903) 952-8431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12199
TX
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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