Provider Demographics
NPI:1598573032
Name:CAVAZOS, LAURA A (LPCA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4713 QUAIL AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9700
Mailing Address - Country:US
Mailing Address - Phone:956-997-1013
Mailing Address - Fax:
Practice Address - Street 1:4713 QUAIL AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9700
Practice Address - Country:US
Practice Address - Phone:956-997-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96458101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor