Provider Demographics
NPI:1588984827
Name:WILLS-BRANDON, CARLA LEA (MA, LMFT, LP)
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:LEA
Last Name:WILLS-BRANDON
Suffix:
Gender:F
Credentials:MA, LMFT, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 AVE O
Mailing Address - Street 2:REAR
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-7839
Mailing Address - Country:US
Mailing Address - Phone:281-338-2992
Mailing Address - Fax:
Practice Address - Street 1:150 W SHADOWBEND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3968
Practice Address - Country:US
Practice Address - Phone:281-338-2992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX#3089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist