| Expansive Light Psychotherapy Pllc | |
|
2640 E League City Pkwy Ste 104-930 League City TX 77573-3368 | |
| (240) 328-8865 | |
| Not Available |
| Full Name | Expansive Light Psychotherapy Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2640 E League City Pkwy Ste 104-930, League City, Texas |
| Authorized Official Name and Position | Tamielle Maree Taylor (MANAGING MEMBER) |
| Authorized Official Contact | 2403288865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Expansive Light Psychotherapy Pllc 2640 E League City Pkwy Ste 104-930 League City TX 77573-3368 Ph: (240) 328-8865 | Expansive Light Psychotherapy Pllc 2640 E League City Pkwy Ste 104-930 League City TX 77573-3368 Ph: (240) 328-8865 |
| NPI Number | 1285498865 |
|---|---|
| Provider Enumeration Date | 02/13/2024 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285498865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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