Provider Demographics
NPI:1194986000
Name:POFF, PAULINE (LCDC,CPS,CJD, ACD)
Entity type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:
Last Name:POFF
Suffix:
Gender:F
Credentials:LCDC,CPS,CJD, ACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BUSINESS DR W
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4326
Mailing Address - Country:US
Mailing Address - Phone:830-896-8884
Mailing Address - Fax:830-367-4687
Practice Address - Street 1:102 BUSINESS DR W
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4326
Practice Address - Country:US
Practice Address - Phone:830-896-8884
Practice Address - Fax:830-367-4687
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7296101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)