MEDICARE: JUANITA A. ARREDONDO LPC-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	64833	TX

General Provider Information

NPI Number	:	1356578827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUANITA A. ARREDONDO LPC-S

Provider Business Mailing Address
First Line	:	3740 COLONY DR. #122
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2234
Country	:	US
Telephone Number	:	210-846-1091
Fax Number	:	210-541-0173

Provider Business Practice Location Address
First Line	:	3740 COLONY DR. #122
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2234
Country	:	US
Telephone Number	:	210-846-1091
Fax Number	:	210-541-0173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	03/16/2018

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