Provider Demographics
NPI:1477689610
Name:AZZOUZ, TERRY L (LPC, LSOTP)
Entity Type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:L
Last Name:AZZOUZ
Suffix:
Gender:F
Credentials:LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11455 ASHFORD WILLOW
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6169
Mailing Address - Country:US
Mailing Address - Phone:281-565-3067
Mailing Address - Fax:281-565-3067
Practice Address - Street 1:11455 ASHFORD WILLOW
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6169
Practice Address - Country:US
Practice Address - Phone:281-565-3067
Practice Address - Fax:281-565-3067
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16335101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional