Provider Demographics
NPI:1790735199
Name:MUNOZ, SHARON RUTH (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:RUTH
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:163 PRIVATE ROAD 938
Mailing Address - Street 2:RR 1 BOX 103C
Mailing Address - City:TEAGUE
Mailing Address - State:TX
Mailing Address - Zip Code:75860-5095
Mailing Address - Country:US
Mailing Address - Phone:254-739-3101
Mailing Address - Fax:903-875-0572
Practice Address - Street 1:872 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2940
Practice Address - Country:US
Practice Address - Phone:903-872-5048
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14272101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional