MEDICARE: MRS. CECILIA C. OZUMBA MA, LMFT, LPC,LCDC

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	101YP2500X	Professional Counselor	3126	TX

General Provider Information

NPI Number	:	1275697849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CECILIA C. OZUMBA MA, LMFT, LPC,LCDC

Provider Business Mailing Address
First Line	:	4608 MAIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-9714
Country	:	US
Telephone Number	:	713-527-0065
Fax Number	:	713-527-8633

Provider Business Practice Location Address
First Line	:	4608 MAIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-9714
Country	:	US
Telephone Number	:	713-527-0065
Fax Number	:	713-527-8633

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/08/2007

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