Healthcare Provider Details

I. General information

NPI: 1598069437
Provider Name (Legal Business Name): DORIS LOUISE ZIBOH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 FREEPORT ST.
HOUSTON TX
77015-3210
US

IV. Provider business mailing address

331 FREEPORT ST
HOUSTON TX
77015-2310
US

V. Phone/Fax

Practice location:
  • Phone: 713-637-6000
  • Fax: 713-637-6009
Mailing address:
  • Phone: 713-637-6000
  • Fax: 713-637-6009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number51173
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: