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General NPI Number Information
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NPI Number | 1992463731
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Entity Type | Individual
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Provider Name | LYDIA BUSSELL
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Gender | Female
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 110 CYPRESS STATION DR
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City | HOUSTON
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State | TX
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Zip | 77090-1630
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Country | US
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Telephone | 800-993-8244
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Fax |
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Provider Business Mailing Address
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Address Line | 8306 ROSE PETALS LN
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City | ROSHARON
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State | TX
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Zip | 77583-1907
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 85428
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License Number State | TX
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