Healthcare Provider Details

I. General information

NPI: 1346584612
Provider Name (Legal Business Name): SARA KUTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12645 MEMORIAL DR STE F1789
HOUSTON TX
77024-4898
US

IV. Provider business mailing address

12645 MEMORIAL DR STE F1 - 789
HOUSTON TX
77024-4979
US

V. Phone/Fax

Practice location:
  • Phone: 281-254-1986
  • Fax:
Mailing address:
  • Phone: 281-254-1986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number66743
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number66743
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number66743
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: