Provider Demographics
NPI:1700326790
Name:ZARDOOST, DENIRA
Entity type:Individual
Prefix:
First Name:DENIRA
Middle Name:
Last Name:ZARDOOST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 CUMMINS ST APT 76
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5827
Mailing Address - Country:US
Mailing Address - Phone:501-764-8546
Mailing Address - Fax:
Practice Address - Street 1:3411 CUMMINS ST APT 76
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5827
Practice Address - Country:US
Practice Address - Phone:501-764-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health