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General NPI Number Information
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NPI Number | 1568805364
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Entity Type | Organization
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Legal Business Name | INTEGRATED BEHAVIORAL HEALTH & WELLNESS CONSULTANTS, PLLC
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 10634 KINGS RIVER DR
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City | ROSHARON
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State | TX
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Zip | 77583-4192
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Country | US
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Telephone | 713-232-0034
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Fax | 800-791-2069
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Provider Business Mailing Address
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Address Line | 10634 KINGS RIVER DR
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City | ROSHARON
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State | TX
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Zip | 77583-4192
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Country | US
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Telephone | 713-232-0034
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Fax | 800-791-2069
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. DIANE MARIE BOUDREAUX
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Credential | PHD
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Telephone | 713-232-0034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35073
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License Number State | TX
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