Provider Demographics
NPI:1356321814
Name:PENDLETON, MARCIETTA GAYLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARCIETTA
Middle Name:GAYLE
Last Name:PENDLETON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14511 MEYERSVILLE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-4323
Mailing Address - Country:US
Mailing Address - Phone:281-458-5905
Mailing Address - Fax:281-458-5905
Practice Address - Street 1:14511 MEYERSVILLE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-4323
Practice Address - Country:US
Practice Address - Phone:281-458-5905
Practice Address - Fax:281-458-5905
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist