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General NPI Number Information
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NPI Number | 1366858532
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Entity Type | Organization
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Legal Business Name | INNER WELLNESS COUNSELING CENTER, PLLC
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 1322 SPACE PARK DR C155
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City | HOUSTON
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State | TX
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Zip | 77058-3400
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Country | US
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Telephone | 713-366-6988
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Fax | 281-214-0507
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Provider Business Mailing Address
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Address Line | 18800 EGRET BAY BLVD 1613
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City | HOUSTON
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State | TX
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Zip | 77058-3834
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Country | US
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Telephone | 713-366-6988
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Fax | 281-214-0507
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Authorized Official
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Title or Position | OWNER
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Name | MARIA DA SILVA
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Credential | LPC
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Telephone | 713-366-6988
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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 | 68150
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License Number State | TX
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