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General NPI Number Information
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NPI Number | 1154048528
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Entity Type | Individual
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Provider Name | CAROLINA DE JONGH
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Gender | Female
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 21415 SNOWBLOSSOM LN
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City | TOMBALL
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State | TX
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Zip | 77375-0490
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Country | US
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Telephone | 713-865-2127
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Fax |
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Provider Business Mailing Address
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Address Line | 8750 SUNSET HEIGHTS LN
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City | CONROE
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State | TX
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Zip | 77302-3436
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Country | US
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Telephone | 713-865-2127
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 85785
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License Number State | TX
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