MEDICARE: TEAIRRA NIANGEL GRICE

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	101YM0800X	Mental Health Counselor	96306	TX

General Provider Information

NPI Number	:	1831663962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEAIRRA NIANGEL GRICE

Provider Business Mailing Address
First Line	:	12807 TELGE RD
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-4103
Country	:	US
Telephone Number	:	502-471-9629
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 BELT LINE RD # 1119
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-4513
Country	:	US
Telephone Number	:	214-631-9208
Fax Number	:

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

Provider Enumeration Date	:	01/11/2019
Last Update Date	:	03/16/2026

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Directions to “ TEAIRRA NIANGEL GRICE ” Practice Location

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