MEDICARE: VERONICA L ANCHONDO M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	19879	TX

General Provider Information

NPI Number	:	1063633923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA L ANCHONDO M.A.

Provider Business Mailing Address
First Line	:	6846 MINERAL RIDGE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-7693
Country	:	US
Telephone Number	:	915-581-9535
Fax Number	:

Provider Business Practice Location Address
First Line	:	6846 MINERAL RIDGE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-7693
Country	:	US
Telephone Number	:	915-581-9535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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