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General NPI Number Information
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NPI Number | 1609202100
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Entity Type | Individual
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Provider Name | SUJA V. CHERIYAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 2400 AUGUSTA DR SUITE 372
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City | HOUSTON
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State | TX
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Zip | 77057-4922
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Country | US
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Telephone | 713-785-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 19901 SOUTHWEST FWY
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City | SUGAR LAND
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State | TX
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Zip | 77479-6538
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Country | US
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Telephone | 281-207-1295
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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 | 31773
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License Number State | TX
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