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NPI Code Detail

MEDICARE: MS. GUADALUPE MADRID MA LPC

MEDICARE: MS. GUADALUPE MADRID MA LPC
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
1101YM0800XMental Health Counselor64827TX

General Provider Information

NPI Number : 1558597161
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GUADALUPE MADRID MA LPC
Provider Business Mailing Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-626-6827
Fax Number : 915-565-3163
Provider Business Practice Location Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-626-6827
Fax Number : 915-565-3163
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2009
Last Update Date : 06/10/2009

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