Provider Demographics
NPI:1699140392
Name:VALDEZ, REBECCA RENAE (LPC-INTERN)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:RENAE
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9030 HERMAN HOLW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6252
Mailing Address - Country:US
Mailing Address - Phone:210-232-0982
Mailing Address - Fax:
Practice Address - Street 1:105 SOUTH STEWART STREET
Practice Address - Street 2:
Practice Address - City:COTULLA
Practice Address - State:TX
Practice Address - Zip Code:78014
Practice Address - Country:US
Practice Address - Phone:830-879-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health