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General NPI Number Information
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NPI Number | 1760148084
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Entity Type | Individual
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Provider Name | JACQUELINE HOUSE
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Gender | Female
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 4119 MONTROSE BLVD
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City | HOUSTON
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State | TX
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Zip | 77006-4963
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Country | US
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Telephone | 512-956-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 MCKEE ST
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City | HOUSTON
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State | TX
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Zip | 77009-8747
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Country | US
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Telephone | 832-605-0836
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 204193
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License Number State | TX
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