Provider Demographics
NPI:1568108868
Name:CANTU, JOSLYN (LSSP)
Entity Type:Individual
Prefix:
First Name:JOSLYN
Middle Name:
Last Name:CANTU
Suffix:
Gender:F
Credentials:LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8603 TESORO HLS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78242-1528
Mailing Address - Country:US
Mailing Address - Phone:210-300-7963
Mailing Address - Fax:
Practice Address - Street 1:8603 TESORO HLS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78242-1528
Practice Address - Country:US
Practice Address - Phone:210-300-7963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72069103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool