Provider Demographics
NPI:1083101356
Name:GUZZARDO, PAULINA NATALIA (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:NATALIA
Last Name:GUZZARDO
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 HIDDEN SPRINGS DR APT 278
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3960
Mailing Address - Country:US
Mailing Address - Phone:347-247-4548
Mailing Address - Fax:
Practice Address - Street 1:1650 W ROSEDALE ST STE 305
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7400
Practice Address - Country:US
Practice Address - Phone:817-381-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-22
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist