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General NPI Number Information
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NPI Number | 1851986590
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Entity Type | Individual
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Provider Name | ANGELA LYNN LONGORIA LMFT-A
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Gender | Female
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 25133 LAKECREST MANOR DR
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City | KATY
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State | TX
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Zip | 77493-3185
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Country | US
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Telephone | 910-447-9211
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Fax |
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Provider Business Mailing Address
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Address Line | 16811 POPLAR HILL ST
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City | HOUSTON
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State | TX
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Zip | 77095-4139
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Country | US
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Telephone | 713-306-6128
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 203900
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License Number State | TX
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