Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 69386 | TX |
NPI | 1003167040 |
---|---|
Provider Name | Cassandra Iris Limon |
First Address | San Antonio, TX 78227-4024 |
Second Address | San Antonio, TX 78227-4024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2012 |
Last Update Date | 16/12/2014 |