Provider Demographics
NPI:1518392745
Name:LOREDO, JOANNA (MA LPC RPT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:LOREDO
Suffix:
Gender:F
Credentials:MA LPC RPT
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 2411
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-2411
Mailing Address - Country:US
Mailing Address - Phone:281-935-8993
Mailing Address - Fax:
Practice Address - Street 1:700 ROCKMEAD DR STE 213
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-235-8993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63820101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional