Provider Demographics
NPI:1447507868
Name:SASAKI, MAHO (MM, MT-BC)
Entity type:Individual
Prefix:
First Name:MAHO
Middle Name:
Last Name:SASAKI
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 OLD SPANISH TRL
Mailing Address - Street 2:#2016
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2154
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 OLD SPANISH TRL
Practice Address - Street 2:#2016
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2154
Practice Address - Country:US
Practice Address - Phone:630-484-3781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10365225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist