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General NPI Number Information
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NPI Number | 1013681261
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Entity Type | Individual
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Provider Name | ROSALYN BIUNDO DETRANALTES
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 3000 WESLAYAN ST STE 140
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City | HOUSTON
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State | TX
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Zip | 77027-5700
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Country | US
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Telephone | 713-804-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 NOTTINGHAM ST
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City | HOUSTON
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State | TX
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Zip | 77005-1409
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Country | US
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Telephone | 832-452-6257
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 85349
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License Number State | TX
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