Provider Demographics
NPI:1750938593
Name:OPPONG, ALEXANDRIA BRIANA (MS, LMFT)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:BRIANA
Last Name:OPPONG
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 DOTSON RD STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4305
Mailing Address - Country:US
Mailing Address - Phone:346-206-3992
Mailing Address - Fax:832-652-3626
Practice Address - Street 1:1095 EVERGREEN CIR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3645
Practice Address - Country:US
Practice Address - Phone:346-206-3992
Practice Address - Fax:832-652-3626
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202884106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist