Provider Demographics
NPI:1538801865
Name:GALLEGOS-WATSON, KIMBERLY PRISCILLA (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:PRISCILLA
Last Name:GALLEGOS-WATSON
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 1:2530 SAGE HOLW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1737
Mailing Address - Country:US
Mailing Address - Phone:956-206-9337
Mailing Address - Fax:
Practice Address - Street 1:2530 SAGE HOLW
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1737
Practice Address - Country:US
Practice Address - Phone:956-206-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87950101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional