Provider Demographics
NPI:1710694419
Name:ALI, FATIMA (NCC)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8119 WAHI LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3404
Mailing Address - Country:US
Mailing Address - Phone:713-837-6110
Mailing Address - Fax:
Practice Address - Street 1:5870 HIGHWAY 6 N STE 310
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1850
Practice Address - Country:US
Practice Address - Phone:281-299-8607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty