Susan Brooke Bagwell, LPC

NPI #1174195200 in Tyler, Texas

Provider Information

NPI Number: 1174195200
Entity Type: Individual
Name: Susan Brooke Bagwell, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Jul 16, 2021
Last Updated: Jul 16, 2021

Practice Location

Address: 3800 PALUXY DR STE 240
City: Tyler
State: Texas
ZIP Code: 75703-1667
Phone: (903) 283-8729

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Professional — Professional	101YP2500X	Primary

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