Healthcare Provider Details

I. General information

NPI: 1053675538
Provider Name (Legal Business Name): MICHELLE SUZETTE PLAMONDON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7037 CAPITOL ST
HOUSTON TX
77011-4643
US

IV. Provider business mailing address

7037 CAPITOL ST
HOUSTON TX
77011-4643
US

V. Phone/Fax

Practice location:
  • Phone: 832-494-1764
  • Fax: 713-926-9105
Mailing address:
  • Phone: 832-494-1764
  • Fax: 713-926-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number64312
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: