Provider Demographics
NPI:1326405341
Name:CUEVAS, BRANDI (LMFT-A)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:DAWN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21518 BLANCO RD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-3381
Mailing Address - Country:US
Mailing Address - Phone:210-701-3337
Mailing Address - Fax:
Practice Address - Street 1:21518 BLANCO RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-3380
Practice Address - Country:US
Practice Address - Phone:210-701-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202431106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist