Provider Demographics
NPI:1396994448
Name:AVALOS, YURI EDUARDO (LPC)
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:EDUARDO
Last Name:AVALOS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 W HOUSTON ST
Mailing Address - Street 2:STE. 902
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2107
Mailing Address - Country:US
Mailing Address - Phone:210-223-9369
Mailing Address - Fax:
Practice Address - Street 1:343 W HOUSTON ST
Practice Address - Street 2:STE. 902
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2107
Practice Address - Country:US
Practice Address - Phone:210-223-9369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62757101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional