Provider Demographics
NPI:1679263172
Name:MARIPOSA PSYCHOTHERAPY AND ASSESSMENTS PLLC
Entity Type:Organization
Organization Name:MARIPOSA PSYCHOTHERAPY AND ASSESSMENTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUESTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-727-8231
Mailing Address - Street 1:400 SURREY LN APT 301
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4158
Mailing Address - Country:US
Mailing Address - Phone:281-727-8231
Mailing Address - Fax:
Practice Address - Street 1:400 SURREY LN APT 301
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4158
Practice Address - Country:US
Practice Address - Phone:281-727-8231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty