Provider Demographics
NPI:1871375360
Name:BURNETT, DEMETRIA (LMFT)
Entity type:Individual
Prefix:
First Name:DEMETRIA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 NORTH LOOP E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-5951
Mailing Address - Country:US
Mailing Address - Phone:832-657-3640
Mailing Address - Fax:713-970-8771
Practice Address - Street 1:7200 NORTH LOOP E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-5951
Practice Address - Country:US
Practice Address - Phone:713-970-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203938106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist