Provider Demographics
NPI:1427410489
Name:VIGEZZI, SYLVANA M (MA,LPC INTERN)
Entity Type:Individual
Prefix:MRS
First Name:SYLVANA
Middle Name:M
Last Name:VIGEZZI
Suffix:
Gender:F
Credentials:MA,LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9262 FOREST LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4207
Mailing Address - Country:US
Mailing Address - Phone:214-692-5001
Mailing Address - Fax:214-692-5750
Practice Address - Street 1:9262 FOREST LN
Practice Address - Street 2:SUITE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4207
Practice Address - Country:US
Practice Address - Phone:214-692-5001
Practice Address - Fax:214-692-5750
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional