Healthcare Provider Details

I. General information

NPI: 1790564151
Provider Name (Legal Business Name): FRANK CHINENYE OGBONNA THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17036 W LITTLE YORK RD STE 6006
HOUSTON TX
77084-6428
US

IV. Provider business mailing address

3737 DACOMA ST
HOUSTON TX
77092-8905
US

V. Phone/Fax

Practice location:
  • Phone: 832-421-6371
  • Fax:
Mailing address:
  • Phone: 832-421-6371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number86870
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: