Provider Demographics
NPI:1083732655
Name:ESCAMILLA, GUADALUPE (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:GUADALUPE
Middle Name:
Last Name:ESCAMILLA
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192126
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-8513
Mailing Address - Country:US
Mailing Address - Phone:214-288-8093
Mailing Address - Fax:214-522-8095
Practice Address - Street 1:4000 RAWLINS ST
Practice Address - Street 2:102
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3649
Practice Address - Country:US
Practice Address - Phone:214-288-8093
Practice Address - Fax:214-522-8095
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional