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General NPI Number Information
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NPI Number | 1063120483
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Entity Type | Individual
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Provider Name | ZAKIYA FORTUNE
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Gender | Female
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 20730 FOX HOUND LN
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City | HUMBLE
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State | TX
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Zip | 77338-1460
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Country | US
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Telephone | 346-329-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 9659 N SAM HOUSTON PKWY E STE. 150, #108
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City | HUMBLE
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State | TX
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Zip | 77396
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Country | US
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Telephone | 346-329-3417
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 56732
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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