Provider Demographics
NPI:1184448342
Name:DE LA GARZA, STEPHANIE (MS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 HIGHWAY 6 S STE B266
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-4206
Mailing Address - Country:US
Mailing Address - Phone:713-482-1985
Mailing Address - Fax:
Practice Address - Street 1:3418 HIGHWAY 6 S STE B266
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-4206
Practice Address - Country:US
Practice Address - Phone:713-482-1985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96413101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional