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General NPI Number Information
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NPI Number | 1013468073
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Entity Type | Individual
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Provider Name | CYNTHIA BANDEMER MA, MPH, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 17300 EL CAMINO REAL STE 107D
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City | HOUSTON
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State | TX
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Zip | 77058
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Country | US
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Telephone | 281-787-5558
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Fax |
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Provider Business Mailing Address
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Address Line | 2323 CLEAR LAKE CITY BLVD STE 180-308
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City | HOUSTON
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State | TX
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Zip | 77062-8120
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Country | US
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Telephone | 281-787-5558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71796
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License Number State | TX
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