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Provider Information for 1619543600

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. LARA ANNE NEELY DBH, MED, CCHT, LPCA

Gender: FEMALE

Individual NPI: 1619543600

Calendar   Last Updated:  2021-06-01
  Certification Date:  2021-06-01

Details

Name Value
NPI 1619543600
Enumeration Date 2021-06-01
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8708 TECHNOLOGY FOREST PL STE 125
THE WOODLANDS, TX 77381-1182
United States

Phone: 291-419-0080 | Fax:
View Map External Link
Primary Practice Address 8708 TECHNOLOGY FOREST PL STE 125
THE WOODLANDS, TX 77381-1182
United States

Phone: 291-419-0080 | Fax: 936-213-9181
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 101YP2500X - Counselor Professional TX 84996