Provider Demographics
NPI:1326762881
Name:BRIONES, EVA LETICIA (MS LPC-A)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:LETICIA
Last Name:BRIONES
Suffix:
Gender:F
Credentials:MS LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 YERMOLAND DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1804
Mailing Address - Country:US
Mailing Address - Phone:915-542-0300
Mailing Address - Fax:
Practice Address - Street 1:8800 YERMOLAND DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-1804
Practice Address - Country:US
Practice Address - Phone:915-504-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80249OtherLPC LICENSE