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General NPI Number Information
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NPI Number | 1548570963
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Entity Type | Individual
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Provider Name | CARLY MALCOLM-HOANG M.A., LPC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 1941 EAST RD SUITE 1236
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City | HOUSTON
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State | TX
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Zip | 77054-6010
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Country | US
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Telephone | 713-486-2832
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Fax | 713-486-2807
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Provider Business Mailing Address
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Address Line | 1941 EAST RD SUITE 1236
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City | HOUSTON
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State | TX
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Zip | 77054-6010
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Country | US
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Telephone | 713-486-2832
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Fax | 713-486-2807
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 62763
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License Number State | TX
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