Provider Demographics
NPI:1679275747
Name:GARZA, PAULINA (LCSW)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:
Last Name:GARZA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAULINA
Other - Middle Name:
Other - Last Name:PANTOJA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9015 WISDOM RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-2110
Mailing Address - Country:US
Mailing Address - Phone:210-849-9999
Mailing Address - Fax:
Practice Address - Street 1:13508 WAXMAN SPARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78252-4615
Practice Address - Country:US
Practice Address - Phone:210-849-1164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health