MEDICARE: ELISA SQUIER LMFT

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
1	106H00000X	Marriage & Family Therapist	203113	TX

General Provider Information

NPI Number	:	1073115804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISA SQUIER LMFT

Provider Business Mailing Address
First Line	:	8831 CAROUSEL LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-6012
Country	:	US
Telephone Number	:	281-636-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	8831 CAROUSEL LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-6012
Country	:	US
Telephone Number	:	281-636-0071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2020
Last Update Date	:	11/16/2020

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Directions to “ ELISA SQUIER LMFT” Practice Location

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