Provider Demographics
NPI:1518624758
Name:GOMEZ ROJAS, ITZELL GEANNELLE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ITZELL
Middle Name:GEANNELLE
Last Name:GOMEZ ROJAS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4366 BRUCE DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2613
Mailing Address - Country:US
Mailing Address - Phone:325-513-3340
Mailing Address - Fax:
Practice Address - Street 1:4225 WOODS PL
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7991
Practice Address - Country:US
Practice Address - Phone:325-513-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional