Provider Demographics
NPI:1598231037
Name:DEAL, DORIS MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:MICHELLE
Last Name:DEAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:MICHELLE
Other - Last Name:RUIZ-DEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:14603 HUEBNER RD STE 3505
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5469
Mailing Address - Country:US
Mailing Address - Phone:210-557-9212
Mailing Address - Fax:
Practice Address - Street 1:14603 HUEBNER RD STE 3505
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5469
Practice Address - Country:US
Practice Address - Phone:210-557-9212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health