Individual
TIA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12430 ASHCROFT DR, HOUSTON, TX 77035-5406
(713) 729-8535
(713) 729-8535
Mailing address
12430 ASHCROFT DR, HOUSTON, TX 77035-5406
(713) 729-8535
(713) 729-8535
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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