Provider Demographics
NPI:1568276525
Name:DEULOFEU ASCENCION, MABEL
Entity type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:DEULOFEU ASCENCION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22100 PARK WESTHEIMER BLVD APT 213
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4214
Mailing Address - Country:US
Mailing Address - Phone:786-992-3153
Mailing Address - Fax:
Practice Address - Street 1:8451 MANTA RAY CIR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-3228
Practice Address - Country:US
Practice Address - Phone:786-992-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24-338039106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician