Provider Demographics
NPI:1316474828
Name:SEIFU, TIZITA
Entity type:Individual
Prefix:
First Name:TIZITA
Middle Name:
Last Name:SEIFU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIZITA
Other - Middle Name:
Other - Last Name:SEIFU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:6808 PASTOR BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-2602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6969 PASTOR BAILEY DR STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2634
Practice Address - Country:US
Practice Address - Phone:214-751-3932
Practice Address - Fax:214-751-3932
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional