Provider Demographics
NPI:1598188872
Name:JOUBERT, ANISSA LATRICE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANISSA
Middle Name:LATRICE
Last Name:JOUBERT
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 1:9923 DRIFTWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2379
Mailing Address - Country:US
Mailing Address - Phone:281-859-6827
Mailing Address - Fax:281-859-6827
Practice Address - Street 1:4902 LOCKWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-2943
Practice Address - Country:US
Practice Address - Phone:832-965-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69557101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional