Provider Demographics
NPI:1255719449
Name:PUENTE, YADIRA G (LPC-S)
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:G
Last Name:PUENTE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:YADIRA
Other - Middle Name:
Other - Last Name:GANDARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3201 CHERRY RIDGE ST STE C318
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4826
Mailing Address - Country:US
Mailing Address - Phone:210-387-2218
Mailing Address - Fax:833-571-1220
Practice Address - Street 1:3201 CHERRY RIDGE DR STE C318
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4826
Practice Address - Country:US
Practice Address - Phone:210-387-2218
Practice Address - Fax:833-571-1220
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional