Provider Demographics
NPI:1013730555
Name:WANCHO, BARBARA MICHELE (LPCA, ASOTP, RN)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MICHELE
Last Name:WANCHO
Suffix:
Gender:F
Credentials:LPCA, ASOTP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7772 CEDAR BREAKS LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-3522
Mailing Address - Country:US
Mailing Address - Phone:915-755-4340
Mailing Address - Fax:
Practice Address - Street 1:1801 WYOMING AVE STE 102
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5707
Practice Address - Country:US
Practice Address - Phone:915-772-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional