Healthcare Provider Details

I. General information

NPI: 1922368687
Provider Name (Legal Business Name): SABRINA JASMYNE EADS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 W BELLFORT ST
HOUSTON TX
77031-2406
US

IV. Provider business mailing address

1831 SHERWOOD FOREST ST APT 3
HOUSTON TX
77043-3010
US

V. Phone/Fax

Practice location:
  • Phone: 713-929-1900
  • Fax:
Mailing address:
  • Phone: 832-364-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number65984
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: