Provider Demographics
NPI:1053446468
Name:NOMURA, KATHRYN MARIAH (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIAH
Last Name:NOMURA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:
Other - Last Name:NOMURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12915 SHADY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2211
Mailing Address - Country:US
Mailing Address - Phone:713-530-7585
Mailing Address - Fax:
Practice Address - Street 1:5638 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6325
Practice Address - Country:US
Practice Address - Phone:281-392-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20284101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health