Provider Demographics
NPI:1205136603
Name:FRIEDEL, CALLEEN MARY (MSLMFTCEAP)
Entity type:Individual
Prefix:MRS
First Name:CALLEEN
Middle Name:MARY
Last Name:FRIEDEL
Suffix:
Gender:F
Credentials:MSLMFTCEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 ROBINSNEST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2129
Mailing Address - Country:US
Mailing Address - Phone:210-376-7236
Mailing Address - Fax:210-598-1910
Practice Address - Street 1:433 KITTY HAWK RD STE 211
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-3829
Practice Address - Country:US
Practice Address - Phone:210-376-7236
Practice Address - Fax:210-598-1910
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4734106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist