Provider Demographics
NPI:1972940104
Name:MAYA-MARTINEZ, AMIRA (LPC)
Entity type:Individual
Prefix:MRS
First Name:AMIRA
Middle Name:
Last Name:MAYA-MARTINEZ
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 1:6628 CAROLINA PNE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3031
Mailing Address - Country:US
Mailing Address - Phone:956-592-7889
Mailing Address - Fax:
Practice Address - Street 1:6628 CAROLINA PNE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3031
Practice Address - Country:US
Practice Address - Phone:956-592-7889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66162101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor