Provider Demographics
NPI:1639277064
Name:VALENZUELA MONCIBAIZ, GRACIELA M (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:GRACIELA
Middle Name:M
Last Name:VALENZUELA MONCIBAIZ
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 AIRPORT FWY STE G125
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7769
Mailing Address - Country:US
Mailing Address - Phone:817-682-1600
Mailing Address - Fax:
Practice Address - Street 1:9001 AIRPORT FWY STE G125
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7769
Practice Address - Country:US
Practice Address - Phone:817-765-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16499101YP2500X
WYLPC-1433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional