Provider Demographics
NPI:1588946560
Name:MINK, AHNA E N (MFT)
Entity type:Individual
Prefix:MRS
First Name:AHNA
Middle Name:E N
Last Name:MINK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 N. MAIN
Mailing Address - Street 2:STE. 740
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212
Mailing Address - Country:US
Mailing Address - Phone:210-271-7411
Mailing Address - Fax:210-271-9414
Practice Address - Street 1:1222 N. MAIN
Practice Address - Street 2:STE. 740
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212
Practice Address - Country:US
Practice Address - Phone:210-271-7411
Practice Address - Fax:210-271-9414
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist