Provider Demographics
NPI:1861641359
Name:CORDOVA, MARIBEL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:A
Last Name:CORDOVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33185 FM 2925
Mailing Address - Street 2:
Mailing Address - City:RIO HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78583-3045
Mailing Address - Country:US
Mailing Address - Phone:956-778-9821
Mailing Address - Fax:956-748-4242
Practice Address - Street 1:33185 FM 2925
Practice Address - Street 2:
Practice Address - City:RIO HONDO
Practice Address - State:TX
Practice Address - Zip Code:78583-3045
Practice Address - Country:US
Practice Address - Phone:956-778-9821
Practice Address - Fax:956-748-4242
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32778103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling