Provider Demographics
NPI:1780963942
Name:CORAZZATO, JULIE ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:CORAZZATO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:WAGUESPACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14015 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SUGARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:832-202-8012
Mailing Address - Fax:832-939-8083
Practice Address - Street 1:14015 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 3
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:832-202-8012
Practice Address - Fax:832-939-8083
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57980101YP2500X
TX101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional