Individual
AMIE IDICULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, M.A.
Contact information
Practice address
2627 CAROLINE ST, HOUSTON, TX 77004-1114
(713) 970-7520
Mailing address
3515 SHOREVIEW LN, MISSOURI CITY, TX 77459-4709
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
72693
TX
Other
Enumeration date
10/02/2016
Last updated
10/02/2016
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