Individual
KELLY TAYLOR-VERVALIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC-I
Contact information
Practice address
1820 COUNTY ROAD 36, ANGLETON, TX 77515-8727
(832) 877-2121
Mailing address
14002 TOWNE WAY DR, SUGAR LAND, TX 77498-1570
(832) 877-2121
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
17430
TX
Other
Enumeration date
07/09/2016
Last updated
07/09/2016
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