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Provider Information for 1073184859


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JANEL ROXANE LONGORIA LPC


Sex: Female

NPI: 1073184859
Last Updated: 2021-07-02
Certification Date: 2021-06-26

Details

NameValue
NPI1073184859
Enumeration Date2021-07-02
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 4830 CEDAR SPRINGS RD APT 15
DALLAS, TX 75219-1363
United States

Phone: 469-500-0223 | Fax:
 
Primary Practice Address 4830 CEDAR SPRINGS RD APT 15
DALLAS, TX 75219-1363
United States

Phone: 469-500-0223 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 193400000X - Single Specialty Group
101YM0800X - Counselor - Mental Health
TX81485