Provider Demographics
NPI:1902200025
Name:HUBER, ANGIE (LPC)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:NUNLEY
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:113 KING PALMS WAY
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-8970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7787 PINEMONT DR STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6216
Practice Address - Country:US
Practice Address - Phone:713-686-9194
Practice Address - Fax:713-686-9413
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66089101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional