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General NPI Number Information
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NPI Number | 1376938365
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Entity Type | Organization
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Legal Business Name | CLAMP NETWORK
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 900 ROCKMEAD DR SUITE 255
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City | KINGWOOD
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State | TX
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Zip | 77339-2115
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Country | US
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Telephone | 281-433-8210
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Fax | 281-898-7622
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Provider Business Mailing Address
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Address Line | 900 ROCKMEAD DR SUITE 255
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City | KINGWOOD
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State | TX
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Zip | 77339-2115
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Country | US
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Telephone | 281-433-8210
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Fax | 281-898-7622
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Authorized Official
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Title or Position | PSYCHOTHERAPIST, SUPERVISOR
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Name | MRS. CAROLA SAENZ-SEPULVEDA
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Credential | LCSW
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Telephone | 281-433-8210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 04233
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License Number State | TX
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