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General NPI Number Information
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NPI Number | 1508222126
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Entity Type | Organization
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Legal Business Name | GRACE INDIVIDUAL AND FAMILY COUNSELING SERVICES INC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 9432 KATY FWY STE 400
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City | HOUSTON
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State | TX
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Zip | 77055-6367
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Country | US
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Telephone | 713-333-6464
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Fax |
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Provider Business Mailing Address
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Address Line | 10727 CLEAR COVE LN
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City | HOUSTON
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State | TX
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Zip | 77041-8704
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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 | PROFESSIONAL THERAPIST
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Name | LAURA E DAVISON
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Credential | LPC
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Telephone | 281-450-3717
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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 | 63388
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License Number State | TX
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