Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101Y00000X | Counselor | 67578 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 14131 | TX |
N | 101YM0800X | Mental Health Counselor | 67578 | TX |
Y | 101YP2500X | Professional Counselor | 67578 | TX |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1023357043 |
---|---|
Provider Name | Ms. Tamara Denise Pena |
First Address | Houston, TX 77054-2693 |
Second Address | Houston, TX 77054-2693 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2013 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023357043 | NPI DATABASE (01) | TX |
1144720889 | NPI DATABASE (01) | TX |