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NPI Code Detail

MEDICARE: IRMA IDALIA MIJARES LPC-A

MEDICARE: IRMA IDALIA MIJARES LPC-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
1101YP2500XProfessional Counselor93563TX

General Provider Information

NPI Number : 1447027636
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRMA IDALIA MIJARES LPC-A
Provider Business Mailing Address
First Line : 2416 EASTERN PALM DR
Second Line :
City : RIO GRANDE CITY
State : TX
Zip : 78582-3467
Country : US
Telephone Number : 956-208-8846
Fax Number :
Provider Business Practice Location Address
First Line : 2416 EASTERN PALM DR
Second Line :
City : RIO GRANDE CITY
State : TX
Zip : 78582-3467
Country : US
Telephone Number : 956-208-8846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2023
Last Update Date : 12/07/2023

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Directions to “ IRMA IDALIA MIJARES LPC-A” Practice Location

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