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General NPI Number Information
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NPI Number | 1033409495
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Entity Type | Organization
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Legal Business Name | HEATHER ROBERTSON
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 22300 SANTA MONICA BLVD
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City | HEMPSTEAD
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State | TX
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Zip | 77445-0426
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Country | US
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Telephone | 979-826-6026
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | PRAIRIE VIEW
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State | TX
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Zip | 77446-0426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | HEATHER ROBERTSON
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Credential |
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Telephone | 832-654-5510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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