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General NPI Number Information
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NPI Number | 1467200162
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Entity Type | Organization
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Legal Business Name | HOUSTON ANXIETY AND WELLNESS CENTER
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Dates
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Enumeration Date | 05/08/2024
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 4306 YOAKUM BLVD STE 510
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City | HOUSTON
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State | TX
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Zip | 77006-5884
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Country | US
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Telephone | 832-444-4749
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Fax |
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Provider Business Mailing Address
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Address Line | 823 KAMANO AVE
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City | HOUSTON
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State | TX
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Zip | 77008-3293
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Country | US
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Telephone | 832-444-4749
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Fax |
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Authorized Official
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Title or Position | OWNER AND CLINICAL DIRECTOR
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Name | DR. IVY RUTHS
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Credential | PHD
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Telephone | 832-444-4749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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