Provider Demographics
NPI:1245120021
Name:DOS SANTOS, ANNA LARISSA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LARISSA
Last Name:DOS SANTOS
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 1:8627 HUFSMITH RD APT 1235
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2876
Mailing Address - Country:US
Mailing Address - Phone:281-732-7959
Mailing Address - Fax:
Practice Address - Street 1:12337 JONES RD STE 114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4844
Practice Address - Country:US
Practice Address - Phone:281-894-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health