Provider Demographics
NPI:1194327239
Name:ACUNA LASSES, NELLIANA (LMFT-A)
Entity type:Individual
Prefix:
First Name:NELLIANA
Middle Name:
Last Name:ACUNA LASSES
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14855 MEMORIAL DR APT 1612
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5247
Mailing Address - Country:US
Mailing Address - Phone:832-879-3086
Mailing Address - Fax:
Practice Address - Street 1:11211 KATY FWY
Practice Address - Street 2:ST. 620
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2126
Practice Address - Country:US
Practice Address - Phone:832-879-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty