Provider Demographics
NPI:1346584612
Name:KUTI, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KUTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12645 MEMORIAL DR
Mailing Address - Street 2:STE F1 - 789
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4979
Mailing Address - Country:US
Mailing Address - Phone:281-254-1986
Mailing Address - Fax:
Practice Address - Street 1:12645 MEMORIAL DR STE F1789
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4898
Practice Address - Country:US
Practice Address - Phone:281-254-1986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66743101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health