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General NPI Number Information
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NPI Number | 1245090612
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Entity Type | Individual
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Provider Name | KATHLEEN ROSE EWELL LPC
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Gender | Female
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 3515 W DALLAS ST APT 7075
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City | HOUSTON
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State | TX
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Zip | 77019-1886
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Country | US
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Telephone | 609-471-3917
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Fax |
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Provider Business Mailing Address
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Address Line | 562 PORTSMOUTH CT
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City | NAPLES
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State | FL
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Zip | 34110-8686
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Country | US
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Telephone | 609-471-3917
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 88274
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License Number State | TX
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