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NPI 1538915004

NPI 1538915004 : KHADESIA SYMONE NEDD LMSW : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1538915004
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    Entity Type          |    Individual 
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    Provider Name        |    KHADESIA SYMONE NEDD LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/25/2024
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    Last Update Date     |    04/25/2024
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Provider Practice Location Address
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    Address Line         |    1335 REGENTS PARK DR STE 140 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77058-2558
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    Country              |    US
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    Telephone            |    832-284-4009
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3928 LAURA LEIGH DR 
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    City                 |    FRIENDSWOOD
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    State                |    TX
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    Zip                  |    77546-4161
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    Country              |    US
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    Telephone            |    281-309-2384
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    109588
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    License Number State |    TX
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