Provider Demographics
NPI:1124031182
Name:DESOBE, SANDRA (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:DESOBE
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17555 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3031
Mailing Address - Country:US
Mailing Address - Phone:281-480-7554
Mailing Address - Fax:281-480-4641
Practice Address - Street 1:17555 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3031
Practice Address - Country:US
Practice Address - Phone:281-480-7554
Practice Address - Fax:281-480-4641
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09707101YP2500X
TX000127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83848LOtherBCBS OF TX