Provider Demographics
NPI:1770358343
Name:MOHIUDDIN, FATIMA (LCSW)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:MOHIUDDIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 DURRETTE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-6412
Mailing Address - Country:US
Mailing Address - Phone:713-398-7015
Mailing Address - Fax:
Practice Address - Street 1:11701 DURRETTE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-6412
Practice Address - Country:US
Practice Address - Phone:713-398-7015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX655831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical