Provider Demographics
NPI:1174824601
Name:ROSS, VITENA RICE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VITENA
Middle Name:RICE
Last Name:ROSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5403 TIMBERS QUAIL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3621
Mailing Address - Country:US
Mailing Address - Phone:281-812-7834
Mailing Address - Fax:281-812-7834
Practice Address - Street 1:5403 TIMBERS QUAIL DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3621
Practice Address - Country:US
Practice Address - Phone:281-812-7834
Practice Address - Fax:281-812-7834
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional