Provider Demographics
NPI:1558824334
Name:WILIE, NATALIE ANN (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:WILIE
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28230 KAILEES CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2053
Mailing Address - Country:US
Mailing Address - Phone:832-283-1702
Mailing Address - Fax:
Practice Address - Street 1:28230 KAILEES CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2053
Practice Address - Country:US
Practice Address - Phone:832-283-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health