Provider Demographics
NPI:1629368329
Name:ANTONGIORGI, DOSELY AUDINA (LPC)
Entity Type:Individual
Prefix:
First Name:DOSELY
Middle Name:AUDINA
Last Name:ANTONGIORGI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 US HWY 90 W
Mailing Address - Street 2:BLDG 2, SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-4030
Mailing Address - Country:US
Mailing Address - Phone:210-521-7273
Mailing Address - Fax:210-521-7278
Practice Address - Street 1:7500 US HWY 90 W
Practice Address - Street 2:BLDG 2, SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-4030
Practice Address - Country:US
Practice Address - Phone:210-521-7273
Practice Address - Fax:210-521-7278
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional