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General NPI Number Information
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NPI Number | 1174303812
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Entity Type | Individual
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Provider Name | JALIA HENRY
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Gender | Female
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 1919 TAYLOR ST STE F
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City | HOUSTON
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State | TX
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Zip | 77007-3973
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Country | US
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Telephone | 832-779-7214
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Fax |
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Provider Business Mailing Address
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Address Line | 18111 MESQUITE ESTATES LN
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City | CYPRESS
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State | TX
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Zip | 77429-4598
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Country | US
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Telephone | 310-988-5604
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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 | 203959
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License Number State | TX
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