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General NPI Number Information
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NPI Number | 1699287680
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Entity Type | Individual
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Provider Name | MARTHA LETICIA CALDERON GALASSI LPC
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Gender | Female
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 1512 E GRIFFIN PKWY # 8
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City | MISSION
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State | TX
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Zip | 78572-2416
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Country | US
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Telephone | 956-424-3433
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Fax | 956-424-3799
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Provider Business Mailing Address
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Address Line | 1512 E GRIFFIN PKWY # 8
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City | MISSION
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State | TX
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Zip | 78572-2416
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Country | US
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Telephone | 956-424-3433
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Fax | 956-424-3799
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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 | 73147
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License Number State | TX
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