Provider Demographics
NPI:1346380300
Name:STILES, MARIE A (CRC, CVE)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:A
Last Name:STILES
Suffix:
Gender:F
Credentials:CRC, CVE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18918 LIVE OAK TRL
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-3559
Mailing Address - Country:US
Mailing Address - Phone:281-351-8606
Mailing Address - Fax:
Practice Address - Street 1:1327 W MAIN ST # 9
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4584
Practice Address - Country:US
Practice Address - Phone:832-623-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00055658101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor