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NPI Code Detail

MEDICARE: AYALA-MYLACRAINE PLLC

MEDICARE: AYALA-MYLACRAINE PLLC
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
1101YP2500XProfessional Counselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QM0850XAdult Mental Health Clinic/Center
4261QM0855XAdolescent and Children Mental Health Clinic/Center
5101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1386400596
Entity Type Code : Organization
Provider Name (Legal Business Name) : AYALA-MYLACRAINE PLLC
Provider Business Mailing Address
First Line : 14350 NORTHBROOK DR STE 140
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-5011
Country : US
Telephone Number : 210-854-5381
Fax Number :
Provider Business Practice Location Address
First Line : 14350 NORTHBROOK DR STE 140
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-5011
Country : US
Telephone Number : 210-854-5381
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : HAZIEL WILLIAMS
Credential : LPC
Telephone Number : 210-854-5380
Provider Enumeration Date : 02/26/2024
Last Update Date : 02/26/2024

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Directions to “AYALA-MYLACRAINE PLLC ” Practice Location

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