Healthcare Provider Details

I. General information

NPI: 1952024978
Provider Name (Legal Business Name): ELIA ANN GUZMAN LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ELIA ANN GUZMAN

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 COUNTY ROAD 5219
D'HANIS TX
78850
US

IV. Provider business mailing address

6335 COUNTY ROAD 5228
HONDO TX
78861-5421
US

V. Phone/Fax

Practice location:
  • Phone: 830-423-7600
  • Fax:
Mailing address:
  • Phone: 830-423-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number89993
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: