Provider Demographics
NPI:1336386085
Name:MCCARDELL, COLLEEN HITCHMAN
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:HITCHMAN
Last Name:MCCARDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:DELORIS
Other - Last Name:HITCHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17418 KENTON CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-0883
Mailing Address - Country:US
Mailing Address - Phone:713-818-0085
Mailing Address - Fax:281-980-8079
Practice Address - Street 1:17418 KENTON CROSSING LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-0883
Practice Address - Country:US
Practice Address - Phone:713-818-0085
Practice Address - Fax:281-980-8079
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-17
Last Update Date:2009-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency