Provider Demographics
NPI:1255620720
Name:SALAZAR LOPEZ, YARED RUTH (LPC)
Entity type:Individual
Prefix:MS
First Name:YARED
Middle Name:RUTH
Last Name:SALAZAR LOPEZ
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:P.O. BOX 6735
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77491
Mailing Address - Country:US
Mailing Address - Phone:832-613-3005
Mailing Address - Fax:
Practice Address - Street 1:11999 KATY FWY
Practice Address - Street 2:SUITE 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1611
Practice Address - Country:US
Practice Address - Phone:832-613-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional