Healthcare Provider Details

I. General information

NPI: 1609651629
Provider Name (Legal Business Name): BRIANNA AURORA VAZQUEZ MA, LPC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 E COPELAND RD STE 420
ARLINGTON TX
76011-1315
US

IV. Provider business mailing address

13870 PASEO CENTRAL AVE
HORIZON CITY TX
79928-8440
US

V. Phone/Fax

Practice location:
  • Phone: 817-631-0976
  • Fax:
Mailing address:
  • Phone: 915-274-6292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number92087
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: