Provider Demographics
NPI:1013583178
Name:YZNAGA, SELMA DE LEON (PHD, LPC, EMDR)
Entity Type:Individual
Prefix:DR
First Name:SELMA
Middle Name:DE LEON
Last Name:YZNAGA
Suffix:
Gender:F
Credentials:PHD, LPC, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 ACACIA DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8004
Mailing Address - Country:US
Mailing Address - Phone:956-533-5762
Mailing Address - Fax:
Practice Address - Street 1:138 ACACIA DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8004
Practice Address - Country:US
Practice Address - Phone:956-533-5762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional