Provider Demographics
NPI:1578076311
Name:SOSA, CHRISTINA (LCDCI)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SOSA
Suffix:
Gender:F
Credentials:LCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10777 STELLA LINK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-5639
Mailing Address - Country:US
Mailing Address - Phone:179-592-9292
Mailing Address - Fax:713-839-8052
Practice Address - Street 1:10777 STELLA LINK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5639
Practice Address - Country:US
Practice Address - Phone:179-592-9292
Practice Address - Fax:713-839-8052
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28643101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)