Provider Demographics
NPI:1669287256
Name:ESCALONA FARIAS, ROSSANA D
Entity type:Individual
Prefix:
First Name:ROSSANA
Middle Name:D
Last Name:ESCALONA FARIAS
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 1:1226 LARKS TRACE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-7504
Mailing Address - Country:US
Mailing Address - Phone:713-309-0309
Mailing Address - Fax:
Practice Address - Street 1:2656 S LOOP W STE 430
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5623
Practice Address - Country:US
Practice Address - Phone:832-431-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97885101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health