Healthcare Provider Details

I. General information

NPI: 1619743275
Provider Name (Legal Business Name): GRACE-JULIA OKOROJI MA, LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7347 SAN RAMON DR
HOUSTON TX
77083-4521
US

IV. Provider business mailing address

7347 SAN RAMON DR
HOUSTON TX
77083-4521
US

V. Phone/Fax

Practice location:
  • Phone: 281-701-2660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number83776
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: