Healthcare Provider Details

I. General information

NPI: 1326405341
Provider Name (Legal Business Name): BRANDI CUEVAS LMFT-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRANDI DAWN TAYLOR

II. Dates (important events)

Enumeration Date: 01/21/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21518 BLANCO RD STE 105
SAN ANTONIO TX
78260-3380
US

IV. Provider business mailing address

21518 BLANCO RD SUITE #105
SAN ANTONIO TX
78260-3381
US

V. Phone/Fax

Practice location:
  • Phone: 210-701-3337
  • Fax:
Mailing address:
  • Phone: 210-701-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number202431
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: