Doctor Name: | MS. CHRISTINA ETUK KIZZEE |
NPI Number: | 1346443066 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 001007699 |
Business Practice Address: | 11970 Wilcrest Dr Ste 102 Houston, TX - 770311923 |
Business Phone Number: | 2815306780 |
Business Fax Number: | 2815308188 |
Mailing Address: | Po Box 769, FRESNO |
State: | TX |
Postal Code: | 775450769 |
Phone Number: | 2815306780 |
Fax Number: | 2815308188 |
NPI Enumeration Date: | 06/08/2007 |
NPI Last Update Date: | 11/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 001007699 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |