Provider Demographics
NPI:1346471810
Name:QUEREAU, JEANNE MARIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:QUEREAU
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 SPECTRUM DR APT 1817
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4127
Mailing Address - Country:US
Mailing Address - Phone:512-342-9552
Mailing Address - Fax:
Practice Address - Street 1:9301 SPECTRUM DR APT 1817
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4127
Practice Address - Country:US
Practice Address - Phone:512-342-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-01
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional