MEDICARE: FAITH WILSON & ASSOCIATES

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	12238	TX

General Provider Information

NPI Number	:	1073878179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITH WILSON & ASSOCIATES

Provider Business Mailing Address
First Line	:	14515 BRIARHILLS PKWY
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77077-1000
Country	:	US
Telephone Number	:	281-741-2828
Fax Number	:

Provider Business Practice Location Address
First Line	:	14515 BRIARHILLS PKWY
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77077-1000
Country	:	US
Telephone Number	:	281-741-2828
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALICE FAITH WILSON
Credential	:	MA., LPC
Telephone Number	:	281-741-2828

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	05/28/2014

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