Provider Demographics
NPI:1033003223
Name:VENCES, VIVIANA
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:
Last Name:VENCES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17207 LOWELL LAKE LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1141
Mailing Address - Country:US
Mailing Address - Phone:713-305-4809
Mailing Address - Fax:
Practice Address - Street 1:17207 LOWELL LAKE LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1141
Practice Address - Country:US
Practice Address - Phone:713-305-4809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health