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General NPI Number Information
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NPI Number | 1073282083
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Entity Type | Organization
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Legal Business Name | SKY SUITE THERAPY SERVICES
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 15211 PARK ROW
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City | HOUSTON
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State | TX
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Zip | 77084
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Country | US
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Telephone | 832-588-3280
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Fax |
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Provider Business Mailing Address
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Address Line | 4919 ORCHARD GARDEN WAY
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City | HOUSTON
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State | TX
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Zip | 77066-3437
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Country | US
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Telephone | 832-588-3280
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. RACHEAL S IRVIN
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Credential | MA, LPC
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Telephone | 832-588-3280
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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 |
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License Number State |
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