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General NPI Number Information
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NPI Number | 1740485804
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Entity Type | Organization
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Legal Business Name | WELL SPRING FAMILY COUNSELING CENTER
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15015 MARLEBONE CT
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City | HOUSTON
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State | TX
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Zip | 77069-2021
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Country | US
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Telephone | 832-859-2417
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Fax | 281-583-8122
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Provider Business Mailing Address
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Address Line | 15015 MARLEBONE CT
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City | HOUSTON
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State | TX
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Zip | 77069-2021
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Country | US
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Telephone | 832-859-2417
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Fax | 281-583-8122
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PEGGY WUNDERLICH-PIPKIN
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Credential | LPC
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Telephone | 832-859-2417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 09720
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License Number State | TX
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