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General NPI Number Information
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NPI Number | 1871048066
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Entity Type | Organization
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Legal Business Name | ERIC C. BURRELL
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 2724 KIPLING ST APT. D132
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City | HOUSTON
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State | TX
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Zip | 77098-1762
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Country | US
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Telephone | 832-457-7842
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Fax |
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Provider Business Mailing Address
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Address Line | 2724 KIPLING ST APT. D132
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City | HOUSTON
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State | TX
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Zip | 77098-1762
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Country | US
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Telephone | 832-457-7842
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC C BURRELL
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Credential | LPC
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Telephone | 832-457-7842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 69981
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License Number State | TX
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