Healthcare Provider Details

I. General information

NPI: 1043824063
Provider Name (Legal Business Name): SYLVIA G. LEDET LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 09/24/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 FM ROAD
RIO HONDO TX
78583
US

IV. Provider business mailing address

PO BOX 611
RIO HONDO TX
78583-0611
US

V. Phone/Fax

Practice location:
  • Phone: 956-499-3252
  • Fax:
Mailing address:
  • Phone: 956-499-3252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number77193
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: