Provider Demographics
NPI:1346549268
Name:GRIZZLE, NADINE GEORGETTE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:NADINE
Middle Name:GEORGETTE
Last Name:GRIZZLE
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 1:6722 ROCKWALL TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3520
Mailing Address - Country:US
Mailing Address - Phone:832-330-8596
Mailing Address - Fax:
Practice Address - Street 1:6722 ROCKWALL TRAIL DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3520
Practice Address - Country:US
Practice Address - Phone:832-330-8596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64591101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional