MEDICARE: MS. AMAL ELIAS ALDAKKOUR 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
1	101YP2500X	Professional Counselor	62449	TX

General Provider Information

NPI Number	:	1417194531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMAL ELIAS ALDAKKOUR LPC

Provider Business Mailing Address
First Line	:	1800 BERING DR
Second Line	:	SUITE 940
City	:	HOUSTON
State	:	TX
Zip	:	77057-3151
Country	:	US
Telephone Number	:	281-921-1818
Fax Number	:	281-912-1919

Provider Business Practice Location Address
First Line	:	1648 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-5255
Country	:	US
Telephone Number	:	281-782-5017
Fax Number	:

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

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	06/19/2009

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