Provider Demographics
NPI:1053039727
Name:BOEN, ANDREA LEIGH (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEIGH
Last Name:BOEN
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 1:307 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2660
Mailing Address - Country:US
Mailing Address - Phone:254-289-8148
Mailing Address - Fax:
Practice Address - Street 1:307 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2660
Practice Address - Country:US
Practice Address - Phone:254-289-8148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84026101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional