| Family Enrichment And Play Therapy Center Inc | |
|
113 S Frazier St Ste 114 Conroe TX 77301-3502 | |
| (281) 785-6451 | |
| Not Available |
| Full Name | Family Enrichment And Play Therapy Center Inc |
|---|---|
| Speciality | Counselor |
| Location | 113 S Frazier St Ste 114, Conroe, Texas |
| Authorized Official Name and Position | Evelyne Kimbriel Fitzgerald (FOUNDER) |
| Authorized Official Contact | 8127856451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Enrichment And Play Therapy Center Inc 1300 S Frazier St Ste 114 Conroe TX 77301-4410 Ph: (812) 785-6451 | Family Enrichment And Play Therapy Center Inc 113 S Frazier St Ste 114 Conroe TX 77301-3502 Ph: (281) 785-6451 |
| NPI Number | 1851789739 |
|---|---|
| Provider Enumeration Date | 12/31/2014 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/22/2024 |
| Medicare PECOS PAC ID | 0446603955 |
|---|---|
| Medicare Enrollment ID | O20240131005057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851789739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 15554 (Texas) | Primary |
| Provider Name | Evelyne Kimbriel Fitzgerald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770097271 PECOS PAC ID: 1355794868 Enrollment ID: I20240131005074 |
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