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11800 Magnolia Pkwy Manvel TX 77578-1800 | |
| (832) 633-5211 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11800 Magnolia Pkwy, Manvel, Texas |
| Authorized Official Name and Position | Ashley Johnson (OWNER) |
| Authorized Official Contact | 8326335211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11800 Magnolia Pkwy Manvel TX 77578-1800 Ph: (832) 633-5211 | 11800 Magnolia Pkwy Manvel TX 77578-1800 Ph: (832) 633-5211 |
| NPI Number | 1134931629 |
|---|---|
| Provider Enumeration Date | 01/22/2025 |
| Last Update Date | 02/05/2025 |
| Certification Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134931629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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