Basic Information
| Provider Information | |||||||||
| NPI: | 1881954519 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAEZ-CURCIO | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 690130 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782690130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107840505 | ||||||||
| FaxNumber: | 3307824750 | ||||||||
| Practice Location | |||||||||
| Address1: | 19230 STONEHUE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782583448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107840505 | ||||||||
| FaxNumber: | 3307824750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2012 | ||||||||
| LastUpdateDate: | 11/06/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 69740 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.