Healthcare Provider Details

I. General information

NPI: 1003722810
Provider Name (Legal Business Name): DEJA CRAYTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5926 MINOR ST
HOUSTON TX
77085-2280
US

IV. Provider business mailing address

5926 MINOR ST
HOUSTON TX
77085-2280
US

V. Phone/Fax

Practice location:
  • Phone: 713-398-7890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103015
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: