Individual
LELA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5911 SOUTHSEAS ST, HOUSTON, TX 77033-1911
(713) 822-7815
(713) 645-0014
Mailing address
5911 SOUTHSEAS ST, HOUSTON, TX 77033-1911
(713) 822-7815
(713) 645-0014
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
TX
101YP2500X
Professional Counselor
—
TX
103T00000X
Psychologist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1138315679
NIJ
TX
01
—
1138754242
RTI
TX
Enumeration date
01/31/2014
Last updated
02/26/2014
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