Provider Demographics
NPI:1942404702
Name:COELHO, CRISTIANE BEZZI
Entity Type:Individual
Prefix:
First Name:CRISTIANE
Middle Name:BEZZI
Last Name:COELHO
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 1:4350 SIGMA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4421
Mailing Address - Country:US
Mailing Address - Phone:972-991-6777
Mailing Address - Fax:972-991-6361
Practice Address - Street 1:4350 SIGMA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-4421
Practice Address - Country:US
Practice Address - Phone:972-991-6777
Practice Address - Fax:972-991-6361
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
TX01-0022171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator