Provider Demographics
NPI:1750124004
Name:HERRERA CORREA, DANIELA C
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:C
Last Name:HERRERA CORREA
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 1:2006 CREEK RUN DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6724
Mailing Address - Country:US
Mailing Address - Phone:520-705-3391
Mailing Address - Fax:
Practice Address - Street 1:633 E FERNHURST DR STE 801
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1587
Practice Address - Country:US
Practice Address - Phone:520-705-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health