Provider Demographics
NPI:1760837413
Name:TORRES, SOFIA GRACIELA (LPC)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:GRACIELA
Last Name:TORRES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 BABCOCK RD
Mailing Address - Street 2:#C201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6304
Mailing Address - Country:US
Mailing Address - Phone:210-531-6492
Mailing Address - Fax:
Practice Address - Street 1:1380 PANTHEON WAY
Practice Address - Street 2:#150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2288
Practice Address - Country:US
Practice Address - Phone:210-531-6492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional