=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770910218
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. DEBORAH D WRIGHT-WHITE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2013
-----------------------------------------------------
Last Update Date | 09/30/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2400 AUGUSTA DR., SUITE 372
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-785-7575
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2400 AUGUSTA DR STE 372
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77057-4954
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-785-7575
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 15504
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------