Provider Demographics
NPI:1043647720
Name:PETERS, GAROLDENE DREWS (LCDC)
Entity Type:Individual
Prefix:
First Name:GAROLDENE
Middle Name:DREWS
Last Name:PETERS
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 GUHN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6161
Mailing Address - Country:US
Mailing Address - Phone:713-783-8889
Mailing Address - Fax:713-783-0499
Practice Address - Street 1:7011 HARWIN DR
Practice Address - Street 2:SUITE 218
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2153
Practice Address - Country:US
Practice Address - Phone:713-783-8894
Practice Address - Fax:713-783-9486
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9085101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)