Provider Demographics
NPI:1104695162
Name:LAZO, STEFHANIE Y
Entity type:Individual
Prefix:MISS
First Name:STEFHANIE
Middle Name:Y
Last Name:LAZO
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 1:14411 WOODGREEN LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77306-4569
Mailing Address - Country:US
Mailing Address - Phone:346-773-9330
Mailing Address - Fax:
Practice Address - Street 1:3327 MADISON ELM ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-4411
Practice Address - Country:US
Practice Address - Phone:832-780-4054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst