Provider Demographics
NPI:1518572239
Name:ALDAZ, MARIA CONSUELO
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CONSUELO
Last Name:ALDAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6328
Mailing Address - Country:US
Mailing Address - Phone:214-941-0798
Mailing Address - Fax:214-941-0408
Practice Address - Street 1:628 CENTRE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6328
Practice Address - Country:US
Practice Address - Phone:214-941-0798
Practice Address - Fax:214-941-0408
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health