Provider Demographics
NPI:1073115804
Name:SQUIER, ELISA (LMFT)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:SQUIER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8831 CAROUSEL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-6012
Mailing Address - Country:US
Mailing Address - Phone:281-636-0071
Mailing Address - Fax:
Practice Address - Street 1:8831 CAROUSEL LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-6012
Practice Address - Country:US
Practice Address - Phone:281-636-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist