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General NPI Number Information
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NPI Number | 1801115126
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Entity Type | Organization
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Legal Business Name | LAURA SECREST, PH.D., PLLC
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 05/26/2010
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Provider Practice Location Address
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Address Line | 800 ROCKMEAD DR SUITE 175
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City | KINGWOOD
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State | TX
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Zip | 77339-2112
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Country | US
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Telephone | 281-780-4776
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Fax | 281-582-6457
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Provider Business Mailing Address
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Address Line | 800 ROCKMEAD DR SUITE 175
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City | KINGWOOD
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State | TX
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Zip | 77339-2112
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Country | US
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Telephone | 281-780-4776
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Fax | 281-582-6457
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. LAURA A SECREST
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Credential | PH.D.
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Telephone | 281-780-4776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 33797
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License Number State | TX
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