Healthcare Provider Details

I. General information

NPI: 1790642015
Provider Name (Legal Business Name): MARCHE AMERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 E 29TH ST UNIT 317
BRYAN TX
77802-3901
US

IV. Provider business mailing address

3708 E 29TH ST UNIT 317
BRYAN TX
77802-3901
US

V. Phone/Fax

Practice location:
  • Phone: 979-220-9894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number98882
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: