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NPI Code Detail

MEDICARE: MRS. RENELDA CLAIRE ROBERSON LPC

MEDICARE: MRS. RENELDA CLAIRE ROBERSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor13806TX

General Provider Information

NPI Number : 1033115662
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RENELDA CLAIRE ROBERSON LPC
Provider Business Mailing Address
First Line : 4519 WHITE ROCK ST
Second Line :
City : HOUSTON
State : TX
Zip : 77051-2041
Country : US
Telephone Number : 713-738-0625
Fax Number :
Provider Business Practice Location Address
First Line : 1319 LIVE OAK ST
Second Line :
City : HOUSTON
State : TX
Zip : 77003-4408
Country : US
Telephone Number : 713-642-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/08/2007

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