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General NPI Number Information
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NPI Number | 1891393542
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Entity Type | Organization
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Legal Business Name | INNER ESSENCE THERAPY, CONSULTING AND DIAGNOSTIC PLLC
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 10800 GOSLING RD UNIT 130142
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City | SPRING
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State | TX
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Zip | 77393-4008
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Country | US
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Telephone | 510-686-3446
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Fax | 832-202-1360
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Provider Business Mailing Address
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Address Line | 10800 GOSLING RD UNIT 130142
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City | SPRING
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State | TX
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Zip | 77393-4008
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Country | US
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Telephone | 510-686-3446
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Fax | 832-202-1360
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | ALISA ZACHERY
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Credential | LCSW
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Telephone | 510-686-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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