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General NPI Number Information
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NPI Number | 1104345248
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Entity Type | Organization
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Legal Business Name | WONDERFULLY MADE YOU COUNSELING, P.C.
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 09/10/2017
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Provider Practice Location Address
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Address Line | 16903 RED OAK DR STE 213
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City | HOUSTON
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State | TX
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Zip | 77090-3915
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Country | US
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Telephone | 254-723-5421
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Fax |
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Provider Business Mailing Address
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Address Line | 17110 HOLLY FALLS CT
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City | HOUSTON
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State | TX
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Zip | 77095-4208
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Country | US
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Telephone | 254-723-5421
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOLANDE FORD
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Credential | LPC
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Telephone | 254-723-5421
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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 | 71838
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License Number State | TX
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