Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 10292 | TX |
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | AE719444D | MS |
N | 101YP2500X | Professional Counselor | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TF0000X | Family Psychologist |
NPI | 1013559988 |
---|---|
Provider Name | Dr. Alice Edwards |
First Address | Houston, TX 77027-3522 |
Second Address | Houston, TX 77027-3522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2019 |
Last Update Date | 16/06/2020 |