MEDICARE: MARIA PETERS MS, 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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1851608004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA PETERS MS, LPC

Provider Business Mailing Address
First Line	:	9611 CAROUSEL LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-5355
Country	:	US
Telephone Number	:	713-412-6646
Fax Number	:	888-959-6774

Provider Business Practice Location Address
First Line	:	2600 GESSNER RD 285
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-3898
Country	:	US
Telephone Number	:	713-412-6646
Fax Number	:	888-959-6774

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

Provider Enumeration Date	:	09/09/2010
Last Update Date	:	07/23/2015

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