Provider Demographics
NPI:1629789904
Name:AYALA, REBECCA MARIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:AYALA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 INDEPENDENCE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4478
Mailing Address - Country:US
Mailing Address - Phone:830-402-5890
Mailing Address - Fax:
Practice Address - Street 1:3016 INDEPENDENCE DR STE 105
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4478
Practice Address - Country:US
Practice Address - Phone:830-402-5890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85781101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health