Provider Demographics
NPI:1811078967
Name:FERNANDEZ, RAQUEL I (MA LPC LMFT)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:I
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MA LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14825 ST MARYS LANE
Mailing Address - Street 2:SUITE 264
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079
Mailing Address - Country:US
Mailing Address - Phone:281-596-9293
Mailing Address - Fax:713-629-4439
Practice Address - Street 1:14825 ST MARYS LN
Practice Address - Street 2:SUITE 264
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079
Practice Address - Country:US
Practice Address - Phone:281-596-9293
Practice Address - Fax:713-629-4439
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC11332101Y00000X
TXLMFT2604106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist