Provider Demographics
NPI:1255111316
Name:GAMMEL, KRISTEN ANN (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:GAMMEL
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANN
Other - Last Name:GAMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANDERSON
Mailing Address - Street 1:3500 HILLCREST DR STE 2B
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-3100
Mailing Address - Country:US
Mailing Address - Phone:254-230-8501
Mailing Address - Fax:254-237-5369
Practice Address - Street 1:3500 HILLCREST DRIVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708
Practice Address - Country:US
Practice Address - Phone:254-230-8501
Practice Address - Fax:254-237-5369
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93045101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional