Provider Demographics
NPI:1144844580
Name:GUERRERO, KATHLYN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KATHLYN
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11926 EDWARD CONRAD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5091
Mailing Address - Country:US
Mailing Address - Phone:956-874-8848
Mailing Address - Fax:
Practice Address - Street 1:9846 LORENE LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4438
Practice Address - Country:US
Practice Address - Phone:830-730-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203118106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist