Provider Demographics
NPI:1700053675
Name:QUINTANILLA, CELINDA (MS, CRC, LPC)
Entity Type:Individual
Prefix:
First Name:CELINDA
Middle Name:
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:MS, CRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 S OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7929
Mailing Address - Country:US
Mailing Address - Phone:956-792-7051
Mailing Address - Fax:
Practice Address - Street 1:1400 E RIDGE RD
Practice Address - Street 2:STE. 1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1535
Practice Address - Country:US
Practice Address - Phone:956-686-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62405101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional