Provider Demographics
NPI:1326655747
Name:VUJOVICH, MINDY LU (LPC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:LU
Last Name:VUJOVICH
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 1:1310 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:LUCAS
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8603
Mailing Address - Country:US
Mailing Address - Phone:406-579-7115
Mailing Address - Fax:
Practice Address - Street 1:1310 ABERDEEN DR
Practice Address - Street 2:
Practice Address - City:LUCAS
Practice Address - State:TX
Practice Address - Zip Code:75002-8603
Practice Address - Country:US
Practice Address - Phone:406-579-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional