Provider Demographics
NPI:1235504408
Name:GARZA, SHELLY LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:LYNN
Last Name:GARZA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W CLARE ST
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-3105
Mailing Address - Country:US
Mailing Address - Phone:361-318-6925
Mailing Address - Fax:
Practice Address - Street 1:702 W CLARE ST
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-3105
Practice Address - Country:US
Practice Address - Phone:361-318-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70348101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional