Provider Demographics
NPI:1922841055
Name:OUZENNE, KENDRA MICHELE (LCDC)
Entity type:Individual
Prefix:MRS
First Name:KENDRA
Middle Name:MICHELE
Last Name:OUZENNE
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 1:29023 FOX FOUNTAIN LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3097
Mailing Address - Country:US
Mailing Address - Phone:832-517-4328
Mailing Address - Fax:
Practice Address - Street 1:5440 HARVEST HILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1607
Practice Address - Country:US
Practice Address - Phone:832-517-4328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16559101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)