Provider Demographics
NPI:1689765810
Name:ROBLES-SAMANIEGO, MARIA ANTONIETA (LPC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANTONIETA
Last Name:ROBLES-SAMANIEGO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MAYAGOITIA-ROBLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2730 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-3811
Mailing Address - Country:US
Mailing Address - Phone:915-252-5889
Mailing Address - Fax:
Practice Address - Street 1:2730 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-3811
Practice Address - Country:US
Practice Address - Phone:915-252-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19353101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7290LCOtherBXBS