Provider Demographics
NPI:1831493907
Name:AGULEFO, PAULINE (MED-LPC)
Entity Type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:
Last Name:AGULEFO
Suffix:
Gender:F
Credentials:MED-LPC
Other - Prefix:MRS
Other - First Name:PAULINE
Other - Middle Name:
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED-LPC
Mailing Address - Street 1:6006 REIGER AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-4581
Mailing Address - Country:US
Mailing Address - Phone:972-502-4120
Mailing Address - Fax:972-564-1151
Practice Address - Street 1:6006 REIGER AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-4581
Practice Address - Country:US
Practice Address - Phone:972-502-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional