Provider Demographics
NPI:1356578827
Name:ARREDONDO, JUANITA A (LPC-S)
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:A
Last Name:ARREDONDO
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 COLONY DR. #122
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2234
Mailing Address - Country:US
Mailing Address - Phone:210-846-1091
Mailing Address - Fax:210-541-0173
Practice Address - Street 1:3740 COLONY DR. #122
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2234
Practice Address - Country:US
Practice Address - Phone:210-846-1091
Practice Address - Fax:210-541-0173
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional