Provider Demographics
NPI:1346616471
Name:UTSUZAWA, NORIKO (MS, LMT, CD)
Entity Type:Individual
Prefix:
First Name:NORIKO
Middle Name:
Last Name:UTSUZAWA
Suffix:
Gender:F
Credentials:MS, LMT, CD
Other - Prefix:
Other - First Name:NOLIKO
Other - Middle Name:
Other - Last Name:UTSUZAWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2314 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2900
Mailing Address - Country:US
Mailing Address - Phone:281-633-6246
Mailing Address - Fax:
Practice Address - Street 1:2314 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2900
Practice Address - Country:US
Practice Address - Phone:281-633-6246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT114621225700000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula