person
Mary Ellen Moore-dominguez
Professional Counselor in Edinburg, Texas
NPI 1992179659

Mary Ellen Moore-dominguez is a Professional Counselor based in Edinburg, TX and is specialized in Professional. Mary Ellen Moore-dominguez practices in Edinburg, TX. The NPI Number for Mary Ellen Moore-dominguez is 1992179659 and holds a License No. 64939 (Texas).

The current practice location address for Mary Ellen Moore-dominguez is 1901 S 24Th Ave, Edinburg, TX and can be reached out via phone at 956-289-7025 and via fax at 956-289-7257.

Location: 1901 S 24Th Ave, Edinburg, TX, 78539-6533
person
Provider Profile Details
NPI Number
1992179659
Provider Name
Mary Ellen Moore-dominguez
Credential
Provider Entity Type
Individual
Gender
Female
Address
1901 S 24Th Ave, Edinburg, TX, 78539-6533
Phone Number
956-289-7025
Fax Number
956-289-7257
Provider Enumeration Date
11/18/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00R945 01 TX MEDICARE
138708611 05 TX
138708613 05 TX
institution
Provider Business Practice Location Address Details
Address
1901 S 24Th Ave
City
State
Zip
78539-6533
Phone Number
956-289-7025
Fax Number
956-289-7257
person
Provider Business Mailing Address Details
Address
1901 S 24Th Ave
City
State
Zip
78539-6533
Phone Number
956-289-7025
Fax Number
956-289-7257
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
64939 (Texas)
Definition
Definition to come...
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