Provider Demographics
NPI:1588831408
Name:GORANONS, RAQUEL F (LPC)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:F
Last Name:GORANONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13610 FAR HILLS LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5534
Mailing Address - Country:US
Mailing Address - Phone:214-886-9977
Mailing Address - Fax:
Practice Address - Street 1:14833 MIDWAY RD
Practice Address - Street 2:SUITE# 210
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001
Practice Address - Country:US
Practice Address - Phone:214-886-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional