| Jacobs Ladder Psychological Services, Pllc | |
|
11201 Richmond Ave Suite A-100a Houston TX 77082-6653 | |
| (281) 512-4734 | |
| (281) 494-8380 |
| Full Name | Jacobs Ladder Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 11201 Richmond Ave, Houston, Texas |
| Authorized Official Name and Position | Keisha Holley Johnson (CEO/PRESIDENT) |
| Authorized Official Contact | 2817857528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobs Ladder Psychological Services, Pllc 16823 Green Quail Dr Missouri City TX 77489-5301 Ph: (281) 512-4734 | Jacobs Ladder Psychological Services, Pllc 11201 Richmond Ave Suite A-100a Houston TX 77082-6653 Ph: (281) 512-4734 |
| NPI Number | 1598005183 |
|---|---|
| Provider Enumeration Date | 02/19/2013 |
| Last Update Date | 05/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598005183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35188 (Texas) | Primary |
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