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General NPI Number Information
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NPI Number | 1942958335
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Entity Type | Individual
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Provider Name | ELEE RENETTA FERGUSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 2002 HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77030-4211
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Country | US
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Telephone | 713-791-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 5222 AVALON PT APT 3306
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City | MISSOURI CITY
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State | TX
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Zip | 77459-1029
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Country | US
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Telephone | 832-208-8583
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 58124
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License Number State | TX
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