Provider Demographics
NPI:1003525148
Name:SAAVEDRA, EDRA B (LPC)
Entity Type:Individual
Prefix:MRS
First Name:EDRA
Middle Name:B
Last Name:SAAVEDRA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WACO ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78401-3030
Mailing Address - Country:US
Mailing Address - Phone:361-886-1484
Mailing Address - Fax:
Practice Address - Street 1:105 WACO ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-3030
Practice Address - Country:US
Practice Address - Phone:361-886-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health