Provider Demographics
NPI:1114898202
Name:SALL, OUMAR
Entity type:Individual
Prefix:
First Name:OUMAR
Middle Name:
Last Name:SALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 CAMBRIA GREEN LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4663
Mailing Address - Country:US
Mailing Address - Phone:346-332-4667
Mailing Address - Fax:
Practice Address - Street 1:213 CAMBRIA GREEN LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-4663
Practice Address - Country:US
Practice Address - Phone:346-332-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor