MEDICARE: MISS GRACE SHIHEN LEU

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	101Y00000X	Counselor	65528	TX

General Provider Information

NPI Number	:	1174755342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS GRACE SHIHEN LEU

Provider Business Mailing Address
First Line	:	3130 WALNUT BEND LN APT 403
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-4759
Country	:	US
Telephone Number	:	281-940-8231
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 WALNUT BEND LN APT 403
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-4759
Country	:	US
Telephone Number	:	281-940-8231
Fax Number	:

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

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/20/2009

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Directions to “ MISS GRACE SHIHEN LEU ” Practice Location

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