Provider Demographics
NPI:1760145460
Name:KOLEOSHO, RASHEEDAT K (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RASHEEDAT
Middle Name:K
Last Name:KOLEOSHO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13810 CHAMPION FOREST DR STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-1883
Mailing Address - Country:US
Mailing Address - Phone:832-702-3702
Mailing Address - Fax:832-234-7593
Practice Address - Street 1:13810 CHAMPION FOREST DR STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1883
Practice Address - Country:US
Practice Address - Phone:832-702-3702
Practice Address - Fax:832-234-7593
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1029119363LP0808X
NY403785363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health