Provider Demographics
NPI:1659019560
Name:FRAIRE, LILI A (LPC)
Entity Type:Individual
Prefix:
First Name:LILI
Middle Name:A
Last Name:FRAIRE
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 1:307 BARREL CACTUS DR
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7070
Mailing Address - Country:US
Mailing Address - Phone:915-383-5459
Mailing Address - Fax:
Practice Address - Street 1:307 BARREL CACTUS DR
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-7070
Practice Address - Country:US
Practice Address - Phone:915-383-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79743101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional