MEDICARE: RANDRYIA LECHE' HOUSTON TAYLOR LCSW

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	1041C0700X	Clinical Social Worker	57285	TX

General Provider Information

NPI Number	:	1346582376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDRYIA LECHE' HOUSTON TAYLOR LCSW

Provider Business Mailing Address
First Line	:	101 FEU FOLLET RD
Second Line	:	STE 100
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-4234
Country	:	US
Telephone Number	:	713-686-9194
Fax Number	:	713-686-9413

Provider Business Practice Location Address
First Line	:	3724 FM 1960 RD W STE 250C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3528
Country	:	US
Telephone Number	:	832-331-4643
Fax Number	:

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

Provider Enumeration Date	:	03/16/2013
Last Update Date	:	05/24/2022

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