Provider Demographics
NPI:1871823161
Name:CANTU, GLORIA P (LPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:P
Last Name:CANTU
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 1:1740 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-3949
Mailing Address - Country:US
Mailing Address - Phone:956-565-6850
Mailing Address - Fax:
Practice Address - Street 1:7272 WURZBACH RD
Practice Address - Street 2:706
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4801
Practice Address - Country:US
Practice Address - Phone:210-615-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4198101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional