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NPI Code Detail

MEDICARE: MS. JENNIPHER MULHOLLEM LPC

MEDICARE: MS. JENNIPHER MULHOLLEM LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor18967TX

General Provider Information

NPI Number : 1114097979
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIPHER MULHOLLEM LPC
Provider Business Mailing Address
First Line : 4950 MEMORIAL DR
Second Line :
City : HOUSTON
State : TX
Zip : 77007-7440
Country : US
Telephone Number : 713-802-3832
Fax Number :
Provider Business Practice Location Address
First Line : 4950 MEMORIAL DR
Second Line :
City : HOUSTON
State : TX
Zip : 77007-7440
Country : US
Telephone Number : 713-802-3832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 07/08/2007

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