Provider Demographics
NPI:1710657929
Name:GUILLORY, ROSELYN S (LPC)
Entity Type:Individual
Prefix:
First Name:ROSELYN
Middle Name:S
Last Name:GUILLORY
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 1:2215 RAPIDS CT
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8833
Mailing Address - Country:US
Mailing Address - Phone:281-716-7799
Mailing Address - Fax:
Practice Address - Street 1:2215 RAPIDS CT
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8833
Practice Address - Country:US
Practice Address - Phone:281-716-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional