Most Relevant Information
Provider Data
| NPI Number: | 1003380460 |
| Provider Name: | ANITA LOUISE LIGHTFOOT LPC INTERN |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 76743 |
Most Important Dates
| Enumeration Date: | 01/17/2019 |
| Last Updated: | 01/17/2019 |
Provider Practice Location
26229 N CRANES MILL RD
CANYON LAKE
TX
781331957
Practice Location Phone/Fax
| Phone: | 8302141559 |
| Fax: |
Provider Mailing Location
26229 N CRANES MILL RD
CANYON LAKE
TX
781331957
Provider Mailing Phone/Fax
| Phone: | 8302141559 |
| Fax: |