Provider Demographics
NPI:1326726852
Name:PRACTICE WELLNESS - COACHING AND COUNSELING LLC
Entity Type:Organization
Organization Name:PRACTICE WELLNESS - COACHING AND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:URIBE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-796-6966
Mailing Address - Street 1:2 LEHIGH SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2666
Mailing Address - Country:US
Mailing Address - Phone:281-796-6966
Mailing Address - Fax:
Practice Address - Street 1:24624 INTERSTATE 45 N STE 257
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4084
Practice Address - Country:US
Practice Address - Phone:281-698-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty