Provider Demographics
NPI:1518604115
Name:SPICER, MARIA GABRIELA (LPC-A)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:GABRIELA
Last Name:SPICER
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:GABRIELA
Other - Last Name:ARAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2864 MILSONS POINT DR
Mailing Address - Street 2:
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-1570
Mailing Address - Country:US
Mailing Address - Phone:817-714-4103
Mailing Address - Fax:
Practice Address - Street 1:1130 N KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-5567
Practice Address - Country:US
Practice Address - Phone:940-331-0446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health