Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 77319 | TX |
N | 101YM0800X | Mental Health Counselor | 77319 | TX |
Y | 101YP2500X | Professional Counselor | 77319 | TX |
N | 101YS0200X | School Counselor | TX |
NPI | 1033688718 |
---|---|
Provider Name | Dr. Sharese Mcneil Martin |
First Address | Cypress, TX 77410-0147 |
Second Address | Houston, TX 77070-3413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2018 |
Last Update Date | 07/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14371575 | CAQH (01) |