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General NPI Number Information
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NPI Number | 1851789739
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Entity Type | Organization
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Legal Business Name | FAMILY ENRICHMENT AND PLAY THERAPY CENTER INC
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Dates
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Enumeration Date | 12/31/2014
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 113 S FRAZIER ST STE 114
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City | CONROE
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State | TX
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Zip | 77301-3502
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Country | US
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Telephone | 281-785-6451
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 S FRAZIER ST STE 114
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City | CONROE
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State | TX
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Zip | 77301-4410
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Country | US
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Telephone | 812-785-6451
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. EVELYNE KIMBRIEL FITZGERALD
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Credential | LPC-S
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Telephone | 812-785-6451
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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 | 15554
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License Number State | TX
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