Provider Demographics
NPI:1508451899
Name:SWEET, CLARISSA RENAE
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:RENAE
Last Name:SWEET
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 1:2148 HAZLITT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-2075
Mailing Address - Country:US
Mailing Address - Phone:281-743-2363
Mailing Address - Fax:
Practice Address - Street 1:6807 LEEDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-2207
Practice Address - Country:US
Practice Address - Phone:281-743-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty