MEDICARE: MRS. JANIE S. GATLIN M. ED., 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	19663	TX

General Provider Information

NPI Number	:	1649576620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANIE S. GATLIN M. ED., LPC

Provider Business Mailing Address
First Line	:	1500 S DAIRY ASHFORD ST
Second Line	:	SUITE 452
City	:	HOUSTON
State	:	TX
Zip	:	77077-3854
Country	:	US
Telephone Number	:	713-857-8577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 S DAIRY ASHFORD ST
Second Line	:	SUITE 452
City	:	HOUSTON
State	:	TX
Zip	:	77077-3854
Country	:	US
Telephone Number	:	713-857-8577
Fax Number	:

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

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	02/08/2011

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