Provider Demographics
NPI:1538468137
Name:VETTRAINO, EUGENE ANTHONY (LPC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:ANTHONY
Last Name:VETTRAINO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 AIRPORT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5759
Mailing Address - Country:US
Mailing Address - Phone:281-239-1324
Mailing Address - Fax:281-232-4312
Practice Address - Street 1:4910 AIRPORT AVE
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5759
Practice Address - Country:US
Practice Address - Phone:281-239-1324
Practice Address - Fax:281-232-4312
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional