Provider Demographics
NPI:1154111961
Name:JANICE, TALISHA
Entity type:Individual
Prefix:
First Name:TALISHA
Middle Name:
Last Name:JANICE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6017 CRANE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-4266
Mailing Address - Country:US
Mailing Address - Phone:832-848-4283
Mailing Address - Fax:
Practice Address - Street 1:16000 BARKERS POINT LN STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4023
Practice Address - Country:US
Practice Address - Phone:832-219-4021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98489101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional