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General NPI Number Information
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NPI Number | 1982318838
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Entity Type | Individual
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Provider Name | BEATRIZ ELENA PRIETO GARZA MA
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Gender | Female
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 4939 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2505
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Country | US
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Telephone | 708-683-9725
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Fax |
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Provider Business Mailing Address
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Address Line | 115 GARFIELD ST APT 2A
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City | OAK PARK
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State | IL
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Zip | 60304-2200
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Country | US
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Telephone | 956-280-9067
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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 | 180016958
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License Number State | IL
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