Provider Demographics
NPI:1487825931
Name:PEREZ, LAURA (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PEREZ
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 1:107 CALLE DEL NORTE STE 14A
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-9104
Mailing Address - Country:US
Mailing Address - Phone:956-523-0152
Mailing Address - Fax:956-796-0404
Practice Address - Street 1:107 CALLE DEL NORTE STE 14A
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-9104
Practice Address - Country:US
Practice Address - Phone:956-523-0152
Practice Address - Fax:956-796-0404
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19944101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional