Provider Demographics
NPI:1548493059
Name:ALCORN, ARMINTIA LATRESE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ARMINTIA
Middle Name:LATRESE
Last Name:ALCORN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 BALSAM GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5361
Mailing Address - Country:US
Mailing Address - Phone:972-274-9603
Mailing Address - Fax:
Practice Address - Street 1:209 BALSAM GROVE CIR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5361
Practice Address - Country:US
Practice Address - Phone:972-274-9603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59958101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional