Individual
COLLEEN C O'GRADY-LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1300 MOURSUND ST, HOUSTON, TX 77030-3406
(713) 500-2500
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
11315
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095407501
—
TX
01
—
83062L
BCBS
TX
Enumeration date
07/10/2006
Last updated
06/17/2008
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