Organization Name: | STONE CREEK PSYCHOTHERAPY |
NPI Number: | 1003009978 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANNE W. APPOLITO (DIRECTOR) |
Mailing Address: | 20915 Kingsland Blvd Katy |
State: | TX US |
Postal Code: | 774505548 |
Phone Number: | 2815790703 |
Fax Number: | 2813989719 |
NPI Enumeration Date: | 08/23/2007 |
NPI Last Update Date: | 08/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 06714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |