Provider Demographics
NPI:1467819250
Name:FRIAS, TERESA PEREZ (LPC, MED)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:PEREZ
Last Name:FRIAS
Suffix:
Gender:F
Credentials:LPC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 MONTWOOD DR STE 116
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-2714
Mailing Address - Country:US
Mailing Address - Phone:915-253-7792
Mailing Address - Fax:
Practice Address - Street 1:10600 MONTWOOD DR STE 116
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2714
Practice Address - Country:US
Practice Address - Phone:915-253-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72403101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional