Provider Demographics
NPI:1902351661
Name:RIAZ, MANAHIL (MED, LPC)
Entity Type:Individual
Prefix:
First Name:MANAHIL
Middle Name:
Last Name:RIAZ
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6575 WEST LOOP S STE 500
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3509
Mailing Address - Country:US
Mailing Address - Phone:346-610-8778
Mailing Address - Fax:
Practice Address - Street 1:6575 WEST LOOP S STE 500
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3509
Practice Address - Country:US
Practice Address - Phone:346-610-8778
Practice Address - Fax:281-524-3003
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional