Provider Demographics
NPI:1568787505
Name:BARAJAS, VERONICA MICHELLE
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:MICHELLE
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:
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 890008
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289-0008
Mailing Address - Country:US
Mailing Address - Phone:713-807-1500
Mailing Address - Fax:713-527-8558
Practice Address - Street 1:6300 GATEWAY BLVD E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2006
Practice Address - Country:US
Practice Address - Phone:915-599-8864
Practice Address - Fax:915-599-3021
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66055101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional