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General NPI Number Information
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NPI Number | 1316777527
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Entity Type | Organization
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Legal Business Name | INCLUSIVE MINDS, PLLC
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Dates
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Enumeration Date | 08/02/2024
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 1486 PASEO DE ENCINAL DR
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City | EAGLE PASS
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State | TX
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Zip | 78852-6445
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Country | US
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Telephone | 210-749-5671
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Fax |
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Provider Business Mailing Address
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Address Line | 1486 PASEO DE ENCINAL DR
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City | EAGLE PASS
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State | TX
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Zip | 78852-6445
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Country | US
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Telephone | 210-749-5671
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SUZANNE Y AYARZA
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Credential | LPC, LCDC
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Telephone | 210-749-5671
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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 |
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License Number State |
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