Healthcare Provider Details

I. General information

NPI: 1962359778
Provider Name (Legal Business Name): AMAKA BARI-NWIZUG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24706 COBBLE CANYON LN
KATY TX
77494-6598
US

IV. Provider business mailing address

24706 COBBLE CANYON LN
KATY TX
77494-6598
US

V. Phone/Fax

Practice location:
  • Phone: 346-218-6403
  • Fax: 346-218-6403
Mailing address:
  • Phone: 346-218-6403
  • Fax: 346-218-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96041
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number96041
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: