Provider Demographics
NPI:1376337071
Name:DUFOUR, KATIE ELLIS
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ELLIS
Last Name:DUFOUR
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 1:20430 CORBIN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0170
Mailing Address - Country:US
Mailing Address - Phone:281-413-9843
Mailing Address - Fax:
Practice Address - Street 1:17920 HUFFMEISTER RD STE 150
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6445
Practice Address - Country:US
Practice Address - Phone:832-421-8714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health