Provider Demographics
NPI:1306694948
Name:BRADEN, TA'LIYA (LPC-A)
Entity type:Individual
Prefix:
First Name:TA'LIYA
Middle Name:
Last Name:BRADEN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 KATY FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2122
Mailing Address - Country:US
Mailing Address - Phone:713-628-3966
Mailing Address - Fax:832-698-9557
Practice Address - Street 1:11211 KATY FWY STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2122
Practice Address - Country:US
Practice Address - Phone:713-628-3966
Practice Address - Fax:832-698-9557
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92203101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional