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General NPI Number Information
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NPI Number | 1043858087
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Entity Type | Organization
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Legal Business Name | EXISTENTIAL PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 2450 FONDREN RD STE 312
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City | HOUSTON
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State | TX
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Zip | 77063-2323
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Country | US
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Telephone | 713-789-7560
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 DREXEL DR
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City | KATY
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State | TX
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Zip | 77493-1710
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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 | MANAGING MEMBER
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Name | DR. MICAH JAMES REES
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Credential |
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Telephone | 801-628-0109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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