Provider Demographics
NPI:1699271304
Name:WUNSCH, MEREDITH MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MICHELLE
Last Name:WUNSCH
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 1:3807 COUNTY ROAD 202
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:76424-7039
Mailing Address - Country:US
Mailing Address - Phone:940-367-8892
Mailing Address - Fax:
Practice Address - Street 1:3807 COUNTY ROAD 202
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-7039
Practice Address - Country:US
Practice Address - Phone:940-367-8892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional