Provider Demographics
NPI:1164122412
Name:DANDY, LOUELA
Entity Type:Individual
Prefix:
First Name:LOUELA
Middle Name:
Last Name:DANDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19707 N VILLAGE OF BRIDGESTONE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6497
Mailing Address - Country:US
Mailing Address - Phone:832-334-2490
Mailing Address - Fax:
Practice Address - Street 1:701 N POST OAK RD STE 145
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3923
Practice Address - Country:US
Practice Address - Phone:713-364-6275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical