Healthcare Provider Details

I. General information

NPI: 1922619311
Provider Name (Legal Business Name): SANAH KOTADIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 WESLAYAN ST STE 274
HOUSTON TX
77027-5740
US

IV. Provider business mailing address

5455 RICHMOND AVE APT 1083
HOUSTON TX
77056-6684
US

V. Phone/Fax

Practice location:
  • Phone: 346-444-9038
  • Fax:
Mailing address:
  • Phone: 817-896-6823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number78921
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: