Individual
GE LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21202 PARK WILLOW DR, KATY, TX 77450-4840
(832) 873-0632
Mailing address
21202 PARK WILLOW DR, KATY, TX 77450-4840
(832) 873-0632
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
67176
TX
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
67176
TX
Other
Enumeration date
09/10/2020
Last updated
03/04/2026
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