Provider Demographics
NPI:1114399292
Name:GUERRERO, ANGELA (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712B SAINT EDWARDS CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5718
Mailing Address - Country:US
Mailing Address - Phone:512-680-5498
Mailing Address - Fax:
Practice Address - Street 1:2712B SAINT EDWARDS CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5718
Practice Address - Country:US
Practice Address - Phone:512-680-5498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health