Provider Demographics
NPI:1225344161
Name:FERNANDEZ, PATRICIA R (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:FERNANDEZ
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 1:4700 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-9624
Mailing Address - Country:US
Mailing Address - Phone:956-639-7787
Mailing Address - Fax:956-838-0873
Practice Address - Street 1:4700 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-9624
Practice Address - Country:US
Practice Address - Phone:956-639-7787
Practice Address - Fax:956-838-0873
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64923101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional