Healthcare Provider Details

I. General information

NPI: 1114691995
Provider Name (Legal Business Name): KATHLEEN O'BRIEN HOTZE LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 WESLAYAN ST
HOUSTON TX
77027-5700
US

IV. Provider business mailing address

10043 LONGMONT DR
HOUSTON TX
77042-2017
US

V. Phone/Fax

Practice location:
  • Phone: 832-655-8008
  • Fax:
Mailing address:
  • Phone: 832-655-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number86629
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: