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General NPI Number Information
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NPI Number | 1548686181
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Entity Type | Individual
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Provider Name | AYESHA FOURNIER
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Gender | Female
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 101 E 15TH ST
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City | AUSTIN
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State | TX
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Zip | 78778-1269
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Country | US
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Telephone | 512-463-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 9523 PALOMA CREEK DR
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City | TOMBALL
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State | TX
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Zip | 77375-8439
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Country | US
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Telephone | 617-909-8465
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10790
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 81923
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 011893
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License Number State | NY
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