Individual
JENELLE ALISE MOUTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2630 SUMMER LN, MISSOURI CITY, TX 77489-1178
(832) 724-5750
Mailing address
2630 SUMMER LN, MISSOURI CITY, TX 77489-1178
(832) 724-5750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17066
TX
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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