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General NPI Number Information
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NPI Number | 1235638420
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Entity Type | Individual
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Provider Name | CORINA CANTU M. ED, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 522 S TEXAS BLVD STE 108
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City | WESLACO
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State | TX
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Zip | 78596-6287
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Country | US
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Telephone | 956-261-5311
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Fax | 956-999-8456
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Provider Business Mailing Address
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Address Line | 2115 SHADOWBROOK CIR
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City | HARLINGEN
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State | TX
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Zip | 78550-3923
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Country | US
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Telephone | 956-778-1332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 70854
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License Number State | TX
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