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General NPI Number Information
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NPI Number | 1982591145
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Entity Type | Organization
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Legal Business Name | HIMPACT PLLC
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 15814 ABERDEEN TRAILS DR
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City | HOUSTON
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State | TX
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Zip | 77095-3750
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Country | US
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Telephone | 832-297-1945
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Fax |
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Provider Business Mailing Address
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Address Line | 15814 ABERDEEN TRAILS DR
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City | HOUSTON
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State | TX
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Zip | 77095-3750
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Country | US
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Telephone | 832-297-1945
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KAMILI WADE-REESCANO
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Credential | LMFT
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Telephone | 832-297-1945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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