Provider Demographics
NPI:1124373154
Name:WADHWANI, NITU B (LPC)
Entity Type:Individual
Prefix:
First Name:NITU
Middle Name:B
Last Name:WADHWANI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 TERRAPIN DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6022
Mailing Address - Country:US
Mailing Address - Phone:254-634-9746
Mailing Address - Fax:
Practice Address - Street 1:758 COUNTY ROAD 417
Practice Address - Street 2:
Practice Address - City:EVANT
Practice Address - State:TX
Practice Address - Zip Code:76525
Practice Address - Country:US
Practice Address - Phone:254-471-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67175101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor