Kodaka, Mitsuru

Kodaka, Mitsuru is an sole proprietor health care provider with primary practice located at 1424 Hemphill St , Fort Worth TX 76104-4703. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Kodaka, Mitsuru can be contacted via phone (817) 759-7942.

Contact Information

Primary practice address
1424 Hemphill St Fort Worth TX 76104-4703
Fax: (817) 665-0878
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-10-6877 Texas

Profile Details

NPI number 1013226653
LBN Legal business name Kodaka, Mitsuru
Credentials M.S., B.C.B.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 30th, 2010
Last updated Sep 30th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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