Provider Demographics
NPI:1518129451
Name:LOZANO, LAURA IRMA (LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:IRMA
Last Name:LOZANO
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 1:819 WATER ST
Mailing Address - Street 2:300
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5333
Mailing Address - Country:US
Mailing Address - Phone:830-258-5430
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:906 E 11TH ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3968
Practice Address - Country:US
Practice Address - Phone:830-774-8702
Practice Address - Fax:830-774-1262
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX61227OtherLPC LICENSE