Provider Demographics
NPI:1679035372
Name:DE LA FUENTE, BRITNEY LEE (LPC-A, LPCI, LVN)
Entity Type:Individual
Prefix:MRS
First Name:BRITNEY
Middle Name:LEE
Last Name:DE LA FUENTE
Suffix:
Gender:F
Credentials:LPC-A, LPCI, LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11502 STALKING WOFT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249
Mailing Address - Country:US
Mailing Address - Phone:210-775-4562
Mailing Address - Fax:
Practice Address - Street 1:11502 STALKING WOFT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249
Practice Address - Country:US
Practice Address - Phone:210-775-4562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85077101YM0800X
TX226612164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health