Provider Demographics
NPI:1982475364
Name:ASSUAGE THERAPY PLLC
Entity Type:Organization
Organization Name:ASSUAGE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:KAMESHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-998-3408
Mailing Address - Street 1:11800 GRANT RD APT 4201
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4038
Mailing Address - Country:US
Mailing Address - Phone:713-998-3408
Mailing Address - Fax:
Practice Address - Street 1:11800 GRANT RD APT 4201
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4038
Practice Address - Country:US
Practice Address - Phone:713-998-3408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)