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General NPI Number Information
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NPI Number | 1407681877
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Entity Type | Individual
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Provider Name | JENNIFER MARIE HAMBLIN LPC-A
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Gender | Female
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 106 AVONDALE ST
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City | HOUSTON
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State | TX
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Zip | 77006-3314
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Country | US
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Telephone | 832-224-9143
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Fax |
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Provider Business Mailing Address
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Address Line | 3119 TRINITY JOE LN
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City | HUMBLE
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State | TX
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Zip | 77396-1943
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Country | US
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Telephone |
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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 | 96286
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License Number State | TX
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