Provider Demographics
NPI:1639415383
Name:AGUILAR, BEATRIZ AYALA (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:AYALA
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1082
Mailing Address - Street 2:
Mailing Address - City:LA BLANCA
Mailing Address - State:TX
Mailing Address - Zip Code:78558-1082
Mailing Address - Country:US
Mailing Address - Phone:956-472-9156
Mailing Address - Fax:
Practice Address - Street 1:10419 MILE 17 N.
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543
Practice Address - Country:US
Practice Address - Phone:956-472-9156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional