Provider Demographics
NPI:1144528506
Name:BRAZIEL, LAURA E (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:BRAZIEL
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 CORPORATE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4001
Mailing Address - Country:US
Mailing Address - Phone:281-690-3456
Mailing Address - Fax:
Practice Address - Street 1:10707 CORPORATE DR STE 203
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4001
Practice Address - Country:US
Practice Address - Phone:281-690-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional