Provider Demographics
NPI:1437206638
Name:CHAPMAN, MARICELA RUBI (LMFT)
Entity Type:Individual
Prefix:
First Name:MARICELA
Middle Name:RUBI
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MARICELA
Other - Middle Name:RUBI
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1519 FLORENCE RD STE 16
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-7903
Mailing Address - Country:US
Mailing Address - Phone:951-662-4038
Mailing Address - Fax:254-774-9315
Practice Address - Street 1:3411 MARKET LOOP STE 106
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2771
Practice Address - Country:US
Practice Address - Phone:951-662-4038
Practice Address - Fax:254-774-9315
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202406106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX340267901Medicaid