Provider Demographics
NPI:1427198571
Name:SHABAZZ-HOUSTON, RABIAH LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:RABIAH
Middle Name:LYNN
Last Name:SHABAZZ-HOUSTON
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 1:1008 IVORY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-1275
Mailing Address - Country:US
Mailing Address - Phone:979-779-5765
Mailing Address - Fax:
Practice Address - Street 1:1008 IVORY RIDGE DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-1275
Practice Address - Country:US
Practice Address - Phone:979-779-5765
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
TX60957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional