Provider Demographics
NPI:1336880061
Name:ABREGO, JUANITA SYLVIA
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:SYLVIA
Last Name:ABREGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 JEWEL CIR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6240
Mailing Address - Country:US
Mailing Address - Phone:956-566-0853
Mailing Address - Fax:
Practice Address - Street 1:2211 JEWEL CIR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6240
Practice Address - Country:US
Practice Address - Phone:956-566-0853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10725101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty