Provider Demographics
NPI:1588030498
Name:VERA, GABRIELA
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:VERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:RAE
Other - Last Name:VERA LEACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 270712
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78427-0712
Mailing Address - Country:US
Mailing Address - Phone:361-946-2256
Mailing Address - Fax:469-535-9009
Practice Address - Street 1:5030 HOLLY RD STE A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4759
Practice Address - Country:US
Practice Address - Phone:361-946-2256
Practice Address - Fax:469-535-9009
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70734101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional