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NPI Code Detail

MEDICARE: INNER AND OUTER GLOW, PLLC

MEDICARE: INNER AND OUTER GLOW, PLLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1568187730
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER AND OUTER GLOW, PLLC
Provider Business Mailing Address
First Line : 701 N POST OAK RD STE 145
Second Line :
City : HOUSTON
State : TX
Zip : 77024-3923
Country : US
Telephone Number : 713-364-6275
Fax Number :
Provider Business Practice Location Address
First Line : 701 N POST OAK RD STE 145
Second Line :
City : HOUSTON
State : TX
Zip : 77024-3923
Country : US
Telephone Number : 713-364-6275
Fax Number :
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MS. K'BREAUN WATKINS
Credential : LCSW
Telephone Number : 281-862-8792
Provider Enumeration Date : 10/10/2022
Last Update Date : 04/02/2024

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Directions to “INNER AND OUTER GLOW, PLLC ” Practice Location

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