Provider Demographics
NPI:1497853345
Name:REYES, MARITZA ELVA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:ELVA
Last Name:REYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 BIRCHWOOD BAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5244
Mailing Address - Country:US
Mailing Address - Phone:210-520-9993
Mailing Address - Fax:
Practice Address - Street 1:3228 SCHOFIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7603
Practice Address - Country:US
Practice Address - Phone:210-808-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
TX305331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical