Provider Demographics
NPI:1588675201
Name:FUENTES, DELMA A (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:DELMA
Middle Name:A
Last Name:FUENTES
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 OAKWELL FARMS PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-1777
Mailing Address - Country:US
Mailing Address - Phone:210-822-4969
Mailing Address - Fax:210-822-4919
Practice Address - Street 1:1919 OAKWELL FARMS PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-1777
Practice Address - Country:US
Practice Address - Phone:210-822-4969
Practice Address - Fax:210-822-4919
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004774-025514106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1522571OtherVALUE OPTIONS
TX3631LCOtherBCBS