Provider Demographics
NPI:1841188869
Name:ZAMORA, MIA ISABELLE (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:ISABELLE
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 PATRICIA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3569
Mailing Address - Country:US
Mailing Address - Phone:210-784-6555
Mailing Address - Fax:
Practice Address - Street 1:13730 PEBBLE OAK DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1816
Practice Address - Country:US
Practice Address - Phone:210-784-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional