Provider Demographics
NPI:1497401806
Name:MUKORO, PRIYE T (LPC)
Entity Type:Individual
Prefix:
First Name:PRIYE
Middle Name:T
Last Name:MUKORO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 FIR CREST CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6006
Mailing Address - Country:US
Mailing Address - Phone:713-419-1148
Mailing Address - Fax:281-261-8772
Practice Address - Street 1:2818 FIR CREST CT
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6006
Practice Address - Country:US
Practice Address - Phone:713-419-1148
Practice Address - Fax:281-261-8772
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83088101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health