Provider Demographics
NPI:1982332938
Name:LIVINGSTON, ENJUELLE
Entity Type:Individual
Prefix:
First Name:ENJUELLE
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315B CYPRESS CREEK PKWY # 508
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25700 I45 SUITE 4300
Practice Address - Street 2:
Practice Address - City:WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77386
Practice Address - Country:US
Practice Address - Phone:765-416-3612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty