Provider Demographics
NPI:1972232106
Name:BALADEZ, YANEL LIANI (LPC)
Entity Type:Individual
Prefix:
First Name:YANEL
Middle Name:LIANI
Last Name:BALADEZ
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 1:5630 WOOD OAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-5037
Mailing Address - Country:US
Mailing Address - Phone:210-677-2742
Mailing Address - Fax:
Practice Address - Street 1:5630 WOOD OAK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-5037
Practice Address - Country:US
Practice Address - Phone:210-701-0182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-04
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73615101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional