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General NPI Number Information
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NPI Number | 1811286065
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Entity Type | Individual
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Provider Name | CELINE MEDLOCK LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 03/28/2011
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Provider Practice Location Address
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Address Line | 11511 KATY FWY SUITE 410
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City | HOUSTON
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State | TX
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Zip | 77079-1903
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Country | US
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Telephone | 713-828-0593
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Fax | 713-784-4040
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Provider Business Mailing Address
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Address Line | 11511 KATY FWY SUITE 410
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City | HOUSTON
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State | TX
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Zip | 77079-1903
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Country | US
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Telephone | 713-828-0593
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Fax | 713-784-4040
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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 | 200886
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License Number State | TX
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