Healthcare Provider Details

I. General information

NPI: 1730849100
Provider Name (Legal Business Name): ESTHER EZIOMA OGBONDA LPC, LCDC-I, BCCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14314 RIVER GLEN DR
SUGAR LAND TX
77498-1755
US

IV. Provider business mailing address

14314 RIVER GLEN DR
SUGAR LAND TX
77498-1755
US

V. Phone/Fax

Practice location:
  • Phone: 832-474-3489
  • Fax:
Mailing address:
  • Phone: 832-474-3489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83522
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: