Provider Demographics
NPI:1992489108
Name:SANCHEZ, RAEGAN (LPC)
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3449 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1733
Mailing Address - Country:US
Mailing Address - Phone:361-402-0088
Mailing Address - Fax:
Practice Address - Street 1:3449 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1733
Practice Address - Country:US
Practice Address - Phone:361-402-0088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional