Provider Demographics
NPI:1063112118
Name:DE LA TORRE, LEAH VIRGINIA (LPC-A)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:VIRGINIA
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14330 HILL PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1131
Mailing Address - Country:US
Mailing Address - Phone:956-286-4426
Mailing Address - Fax:
Practice Address - Street 1:14330 HILL PRINCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1131
Practice Address - Country:US
Practice Address - Phone:956-286-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional