Provider Demographics
NPI:1295407286
Name:NATIVIDAD, ANNIE CHRISTINE (LPC)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:CHRISTINE
Last Name:NATIVIDAD
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 1:2032 HIDDEN LK
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-5648
Mailing Address - Country:US
Mailing Address - Phone:361-425-7652
Mailing Address - Fax:
Practice Address - Street 1:2032 HIDDEN LK
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-5648
Practice Address - Country:US
Practice Address - Phone:361-425-7652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72197101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor