| Passionate Life Therapeutic Alliance, Pllc | |
|
7676 Hillmont St Ste 344-04 Houston TX 77040-6400 | |
| (832) 224-5092 | |
| Not Available |
| Full Name | Passionate Life Therapeutic Alliance, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 7676 Hillmont St Ste 344-04, Houston, Texas |
| Authorized Official Name and Position | Lacy Isenburg (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8322245092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passionate Life Therapeutic Alliance, Pllc 7676 Hillmont St Ste 344-04 Houston TX 77040-6400 Ph: (832) 224-5092 | Passionate Life Therapeutic Alliance, Pllc 7676 Hillmont St Ste 344-04 Houston TX 77040-6400 Ph: (832) 224-5092 |
| NPI Number | 1003513649 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 07/11/2023 |
| Certification Date | 07/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003513649 | NPI | - | NPPES |
| 79539 | Other | TX | LPC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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