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General NPI Number Information
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NPI Number | 1083717698
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Entity Type | Individual
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Provider Name | LEE T WILLIS MA LPC RN
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 401 BRANARD ST
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City | HOUSTON
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State | TX
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Zip | 77006-5015
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Country | US
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Telephone | 713-529-0037
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Fax | 713-526-4367
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Provider Business Mailing Address
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Address Line | 401 BRANARD ST
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City | HOUSTON
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State | TX
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Zip | 77006-5015
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Country | US
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Telephone | 713-529-0037
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Fax | 713-526-4367
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 9496
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 421862
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License Number State | TX
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