Provider Demographics
NPI:1689436685
Name:BARRATACHEA, BIANCA LYNN
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:LYNN
Last Name:BARRATACHEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 AUSTIN HWY STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5303
Mailing Address - Country:US
Mailing Address - Phone:210-750-3148
Mailing Address - Fax:
Practice Address - Street 1:300 AUSTIN HWY STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5303
Practice Address - Country:US
Practice Address - Phone:210-750-3148
Practice Address - Fax:833-962-6211
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional