Provider Demographics
NPI:1629604780
Name:LOZANO, ERIN (MED, LPC-S, RPT-S)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:MED, LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5801
Mailing Address - Country:US
Mailing Address - Phone:469-358-1308
Mailing Address - Fax:
Practice Address - Street 1:121 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5801
Practice Address - Country:US
Practice Address - Phone:469-358-1308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59765101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor