Provider Demographics
NPI:1477263390
Name:GARZA, VIVIANA (LPC, LSSP)
Entity Type:Individual
Prefix:DR
First Name:VIVIANA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:LPC, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:LA JOYA
Mailing Address - State:TX
Mailing Address - Zip Code:78560-0146
Mailing Address - Country:US
Mailing Address - Phone:956-266-3082
Mailing Address - Fax:
Practice Address - Street 1:836 E EXPRESSWAY 83
Practice Address - Street 2:SUITE B (PRO CARE DME)
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560-4178
Practice Address - Country:US
Practice Address - Phone:956-266-3082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional