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General NPI Number Information
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NPI Number | 1760827620
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Entity Type | Organization
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Legal Business Name | GREEN THERAPY AND CONSULTATION LLC
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 155 BIRDSALL ST APT 342
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City | HOUSTON
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State | TX
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Zip | 77007-8187
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Country | US
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Telephone | 713-364-5782
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Fax |
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Provider Business Mailing Address
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Address Line | 155 BIRDSALL ST APT 342
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City | HOUSTON
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State | TX
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Zip | 77007-8187
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Country | US
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Telephone | 713-364-5782
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Fax | 346-214-6031
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDRA GREEN
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Credential |
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Telephone | 713-364-5782
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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 | 180008519
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License Number State | IL
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 76600
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License Number State | TX
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