Healthcare Provider Details

I. General information

NPI: 1699686626
Provider Name (Legal Business Name): PETAL PATH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 33RD ST
HIDALGO TX
78557-3796
US

IV. Provider business mailing address

1205 33RD ST
HIDALGO TX
78557-3796
US

V. Phone/Fax

Practice location:
  • Phone: 956-884-8389
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LIZA MOLINA
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 956-884-8389