Provider Demographics
NPI:1255108023
Name:LOZANO, BREANNA (LPC-A)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ADAM LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-5327
Mailing Address - Country:US
Mailing Address - Phone:361-960-0776
Mailing Address - Fax:
Practice Address - Street 1:3313 DAMICO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-1905
Practice Address - Country:US
Practice Address - Phone:361-960-0776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health