Provider Demographics
NPI:1588328868
Name:LOZANO, VANESSA ANJELINA (MA, LPC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANJELINA
Last Name:LOZANO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10225 FM 1886
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-1131
Mailing Address - Country:US
Mailing Address - Phone:682-554-7754
Mailing Address - Fax:
Practice Address - Street 1:10225 FM 1886
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-1131
Practice Address - Country:US
Practice Address - Phone:682-554-7754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-24
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health