Provider Demographics
NPI:1851867162
Name:FENNIE, TONI M (LPC)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:M
Last Name:FENNIE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16926 SKY BLUE PL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1265
Mailing Address - Country:US
Mailing Address - Phone:281-975-8432
Mailing Address - Fax:
Practice Address - Street 1:6601 CYPRESSWOOD DR STE 114
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7892
Practice Address - Country:US
Practice Address - Phone:281-803-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional