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General NPI Number Information
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NPI Number | 1174108294
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Entity Type | Individual
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Provider Name | MICHELLE RENEE COSART LPC
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Gender | Female
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 1327 W MAIN ST STE 2
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City | TOMBALL
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State | TX
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Zip | 77375-5548
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Country | US
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Telephone | 832-299-8863
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Fax | 346-336-6119
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Provider Business Mailing Address
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Address Line | 22730 NEWCOURT PLACE ST
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City | TOMBALL
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State | TX
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Zip | 77375-1125
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Country | US
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Telephone | 832-299-8863
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Fax | 346-336-6119
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 81513
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License Number State | TX
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