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General NPI Number Information
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NPI Number | 1831740299
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Entity Type | Organization
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Legal Business Name | KRISTEN CHAMBLISS, PH.D., PLLC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 1506 E. WINDING WAY DR. SUITE 606
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City | FRIENDSWOOD
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State | TX
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Zip | 77546
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Country | US
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Telephone | 281-324-0503
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Fax |
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Provider Business Mailing Address
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Address Line | 1506 E. WINDING WAY DR. SUITE 606
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City | FRIENDSWOOD
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State | TX
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Zip | 77546
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Country | US
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Telephone | 281-324-0503
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Fax |
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Authorized Official
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Title or Position | LICENSE PSYCHOLOGIST
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Name | KRISTEN CHAMBLISS
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Credential |
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Telephone | 281-324-0503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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