MEDICARE: MRS. TERRI ADESHOLA 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
1	101YP2500X	Professional Counselor	62914	TX

General Provider Information

NPI Number	:	1134332828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRI ADESHOLA LPC

Provider Business Mailing Address
First Line	:	8700 COMMERCE PARK DR
Second Line	:	SUITE 219
City	:	HOUSTON
State	:	TX
Zip	:	77036-7497
Country	:	US
Telephone Number	:	713-771-5151
Fax Number	:	713-771-5156

Provider Business Practice Location Address
First Line	:	8700 COMMERCE PARK DR
Second Line	:	SUITE 219
City	:	HOUSTON
State	:	TX
Zip	:	77036-7497
Country	:	US
Telephone Number	:	713-771-5151
Fax Number	:	713-771-5156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	08/13/2010

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