Provider Demographics
NPI:1396425369
Name:VOMERO, PRISCILLA GAMBOA (LPC)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:GAMBOA
Last Name:VOMERO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 COPPERFIELD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3111
Mailing Address - Country:US
Mailing Address - Phone:210-859-8900
Mailing Address - Fax:
Practice Address - Street 1:1822 COPPERFIELD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3111
Practice Address - Country:US
Practice Address - Phone:210-859-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87726101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor