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General NPI Number Information
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NPI Number | 1508749771
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Entity Type | Individual
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Provider Name | KEENAH ORELIA BRAZILE
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 16770 IMPERIAL VALLEY DR STE 125E
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City | HOUSTON
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State | TX
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Zip | 77060-3427
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Country | US
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Telephone | 713-240-3946
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Fax |
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Provider Business Mailing Address
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Address Line | 8810 LIVINGS ST
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City | HOUSTON
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State | TX
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Zip | 77028-4582
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 93790
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 93790
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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