Provider Demographics
NPI:1124326582
Name:MURRAY, ROSIETTA S (LCDC)
Entity type:Individual
Prefix:MS
First Name:ROSIETTA
Middle Name:S
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6103 SHADOW ISLE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6799
Mailing Address - Country:US
Mailing Address - Phone:832-289-7565
Mailing Address - Fax:832-289-7565
Practice Address - Street 1:6103 SHADOW ISLE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6799
Practice Address - Country:US
Practice Address - Phone:832-289-7565
Practice Address - Fax:832-289-7565
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9550101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)