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General NPI Number Information
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NPI Number | 1104993377
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Entity Type | Individual
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Provider Name | MARCIA D PETERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 2818 WEST T.C. JESTER BLVD. NONE (MAILING ADDRESS)
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City | HOUSTON
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State | TX
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Zip | 77018
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Country | US
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Telephone | 713-298-1495
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Fax |
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Provider Business Mailing Address
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Address Line | 2815 WEST T.C. JESTER BLVD.
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City | HOUSTON
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State | TX
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Zip | 77018
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Country | US
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Telephone | 713-298-1495
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27449
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License Number State | TX
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