Provider Demographics
NPI:1720165855
Name:LESTER, JUDITH L (MA IN COUNSELING)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:L
Last Name:LESTER
Suffix:
Gender:F
Credentials:MA IN COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 S HULEN ST
Mailing Address - Street 2:SUITE 686
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4914
Mailing Address - Country:US
Mailing Address - Phone:817-370-2636
Mailing Address - Fax:817-732-3258
Practice Address - Street 1:4200 S HULEN ST
Practice Address - Street 2:SUITE 686
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4914
Practice Address - Country:US
Practice Address - Phone:817-370-2636
Practice Address - Fax:817-732-3258
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMFT 702101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor