Provider Demographics
NPI:1396376802
Name:GALARZA, JASMIN (MS, LCDC, LMFT, LPC-)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:GALARZA
Suffix:
Gender:F
Credentials:MS, LCDC, LMFT, LPC-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 PIDDLER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-6256
Mailing Address - Country:US
Mailing Address - Phone:832-202-5614
Mailing Address - Fax:
Practice Address - Street 1:2406 PIDDLER DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-6256
Practice Address - Country:US
Practice Address - Phone:832-202-5614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203000Medicaid