MEDICARE: MS. NAZIA ISLAM LPC-S

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	101Y00000X	Counselor	68697	TX

General Provider Information

NPI Number	:	1710387493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAZIA ISLAM LPC-S

Provider Business Mailing Address
First Line	:	950 ECHO LN STE 350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2750
Country	:	US
Telephone Number	:	832-639-2015
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 ECHO LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2756
Country	:	US
Telephone Number	:	832-639-2015
Fax Number	:

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

Provider Enumeration Date	:	08/29/2014
Last Update Date	:	12/29/2022

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