Individual
JACQUELINE MBUAGBAW FOSAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1504 BEN TAUB LOOP, HOUSTON, TX 77030
(712) 873-2000
Mailing address
5635 W HARROW DR, HOUSTON, TX 77084-1869
(651) 398-2927
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP145962
TX
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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