Provider Demographics
NPI:1720771843
Name:NOURIN, MOWNITA
Entity Type:Individual
Prefix:
First Name:MOWNITA
Middle Name:
Last Name:NOURIN
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 1:3839 BRIARGROVE LN APT 1305
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6362
Mailing Address - Country:US
Mailing Address - Phone:469-440-9722
Mailing Address - Fax:
Practice Address - Street 1:2419 COIT RD STE C
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3731
Practice Address - Country:US
Practice Address - Phone:469-440-9722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional