Provider Demographics
NPI:1306519533
Name:GOPAL, SUDHA (NBC-HWC, FMCHC)
Entity type:Individual
Prefix:
First Name:SUDHA
Middle Name:
Last Name:GOPAL
Suffix:
Gender:F
Credentials:NBC-HWC, FMCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 DEERHURST DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3123
Mailing Address - Country:US
Mailing Address - Phone:972-978-2936
Mailing Address - Fax:
Practice Address - Street 1:4212 DEERHURST DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3123
Practice Address - Country:US
Practice Address - Phone:972-978-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach