Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 102L00000X | Psychologist | 38592 | TX |
Y | 103T00000X | Psychologist | 38592 | TX |
NPI | 1003106006 |
---|---|
Provider Name | Ms. Yolanda Valenzuela |
First Address | Fort Worth, TX 76199-0213 |
Second Address | Fort Worth, TX 76104-2722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 21/11/2021 |