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General NPI Number Information
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NPI Number | 1760013106
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Entity Type | Individual
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Provider Name | JODY LUEDDE LPC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 500 MASON ST
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City | TOMBALL
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State | TX
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Zip | 77375-4450
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Country | US
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Telephone | 281-255-9922
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Fax | 281-255-9064
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Provider Business Mailing Address
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Address Line | 500 MASON ST
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City | TOMBALL
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State | TX
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Zip | 77375-4450
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Country | US
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Telephone | 281-255-9922
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Fax | 281-255-9064
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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 | 78172
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License Number State | TX
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