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Individual

LEE T WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA LPC RN

Contact information

Practice address
401 BRANARD ST, HOUSTON, TX 77006-5015
(713) 529-0037
(713) 526-4367
Mailing address
401 BRANARD ST, HOUSTON, TX 77006-5015
(713) 529-0037
(713) 526-4367

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
9496
TX
163W00000X
Registered Nurse
421862
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
095412501
TX
01
82228L
BCBS
TX
Enumeration date
09/07/2006
Last updated
03/03/2009
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