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General NPI Number Information
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NPI Number | 1003015777
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Entity Type | Organization
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Legal Business Name | SIGHBENN HEALING AND CULTURAL PLACE
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 26515 OAK RIDGE DR
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1966
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Country | US
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Telephone | 281-367-0328
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Fax | 281-419-9753
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Provider Business Mailing Address
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Address Line | 26515 OAK RIDGE DR
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1966
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Country | US
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Telephone | 281-367-0328
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Fax | 281-419-9753
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | MISSID G GHANEM
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Credential | MPH, PSY.D
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Telephone | 281-367-0328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 26864
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License Number State | TX
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