Healthcare Provider Details

I. General information

NPI: 1982947289
Provider Name (Legal Business Name): EMBRACE LIFE COUNSELING & CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1846 SNAKE RIVER RD STE B
KATY TX
77449-7758
US

IV. Provider business mailing address

1846 SNAKE RIVER RD STE B
KATY TX
77449-7758
US

V. Phone/Fax

Practice location:
  • Phone: 281-945-2167
  • Fax:
Mailing address:
  • Phone: 281-945-2167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number65046
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHY MANUEL
Title or Position: DIRECTOR
Credential: M.ED., LPC
Phone: 832-671-0067