=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528249059
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLARA SLODOWNIK ROSENZWEIG M.ED., L.P.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/27/2007
-----------------------------------------------------
Last Update Date | 06/03/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 424 HAHLO ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77020-3022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-343-5508
-----------------------------------------------------
Fax | 713-343-5473
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 424 HAHLO ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77020-3022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-343-5508
-----------------------------------------------------
Fax | 713-343-5473
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 63312
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------