Individual
INJILA IMAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 SUGAR GROVE BLVD STE 275, STAFFORD, TX 77477-2150
(281) 624-8871
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
90133
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373188702
—
TX
01
—
90133
LICENSE
TX
Enumeration date
08/15/2022
Last updated
03/24/2025
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