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Organization
PASSIONATE LIFE THERAPEUTIC ALLIANCE, PLLC
Active
Organization
PASSIONATE LIFE THERAPEUTIC ALLIANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACY ISENBURG LPC (AUTHORIZED OFFICIAL)
(832) 224-5092
Entity
Organization
Contact information
Practice address
7676 HILLMONT ST STE 344-04, HOUSTON, TX 77040-6400
(832) 224-5092
Mailing address
7676 HILLMONT ST STE 344-04, HOUSTON, TX 77040-6400
(832) 224-5092
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79539
LPC LICENSE
TX
Enumeration date
02/14/2023
Last updated
07/11/2023
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