Provider Demographics
NPI:1568771889
Name:FERNANDEZ, MARCELA LETICIA (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARCELA
Middle Name:LETICIA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-4438
Mailing Address - Country:US
Mailing Address - Phone:956-536-6666
Mailing Address - Fax:
Practice Address - Street 1:722 MORGAN BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5139
Practice Address - Country:US
Practice Address - Phone:956-536-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional