Doctor Name: | HILDEBRANDO MIRELES |
NPI Number: | 1083941686 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC-I |
License Number: | 654437 |
Business Practice Address: | 1089 Del Rio Blvd Ste A Eagle Pass, TX - 788523453 |
Business Phone Number: | 8307570117 |
Business Fax Number: | 8307570119 |
Mailing Address: | 1089 Del Rio Blvd Ste A, EAGLE PASS |
State: | TX |
Postal Code: | 788523453 |
Phone Number: | 8307570117 |
Fax Number: | 8307570119 |
NPI Enumeration Date: | 11/03/2009 |
NPI Last Update Date: | 11/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 654437 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |