Provider Demographics
NPI:1427572056
Name:HARRIS, HYTHIA DIEDRE (LBSW)
Entity Type:Individual
Prefix:MS
First Name:HYTHIA
Middle Name:DIEDRE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:HYTHIA
Other - Middle Name:DIEDRE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12379 S DAIRY ASHFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3937
Mailing Address - Country:US
Mailing Address - Phone:713-816-8995
Mailing Address - Fax:
Practice Address - Street 1:12379 S DAIRY ASHFORD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3937
Practice Address - Country:US
Practice Address - Phone:713-816-8995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27799101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor