Individual
HALIE DOMINGUE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1348 HEIGHTS BLVD, HOUSTON, TX 77008-4209
(512) 751-3791
Mailing address
1348 HEIGHTS BLVD, HOUSTON, TX 77008-4209
(512) 751-3791
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
63398
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26734161
DRIVER'S LICENSE
TX
Enumeration date
09/02/2022
Last updated
09/02/2022
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