Provider Demographics
NPI:1881753879
Name:AVALOS, MARIA TERESA (EDM LMHC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:AVALOS
Suffix:
Gender:F
Credentials:EDM LMHC
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:AVALOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4464
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99302-4464
Mailing Address - Country:US
Mailing Address - Phone:509-851-7740
Mailing Address - Fax:509-542-8836
Practice Address - Street 1:8350 W GRANDRIDGE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1678
Practice Address - Country:US
Practice Address - Phone:509-851-7740
Practice Address - Fax:509-546-0520
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health