Provider Demographics
NPI:1881725505
Name:BARRON, MOZELLE (MED,LPC)
Entity type:Individual
Prefix:
First Name:MOZELLE
Middle Name:
Last Name:BARRON
Suffix:
Gender:F
Credentials:MED,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 BARNARD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8461
Mailing Address - Country:US
Mailing Address - Phone:956-546-5400
Mailing Address - Fax:956-546-5783
Practice Address - Street 1:2355 BARNARD RD
Practice Address - Street 2:SUITE C
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8461
Practice Address - Country:US
Practice Address - Phone:956-546-5400
Practice Address - Fax:956-546-5783
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional