Provider Demographics
NPI:1073148821
Name:PARRA, ANALY (LPA)
Entity Type:Individual
Prefix:
First Name:ANALY
Middle Name:
Last Name:PARRA
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 JUDSON RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5120
Mailing Address - Country:US
Mailing Address - Phone:903-200-1433
Mailing Address - Fax:
Practice Address - Street 1:1125 JUDSON RD STE 150
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5120
Practice Address - Country:US
Practice Address - Phone:903-200-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38424101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health