Provider Demographics
NPI:1386211548
Name:NEAL, CAMIEL CASSANDRA
Entity Type:Individual
Prefix:
First Name:CAMIEL
Middle Name:CASSANDRA
Last Name:NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16611 HOLLOW RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77053-5339
Mailing Address - Country:US
Mailing Address - Phone:713-213-1016
Mailing Address - Fax:
Practice Address - Street 1:16611 HOLLOW RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77053-5339
Practice Address - Country:US
Practice Address - Phone:713-213-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80061101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80061OtherLPC