Provider Demographics
NPI:1356962229
Name:MOCZYGEMBA, VALERIE J (LPC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:J
Last Name:MOCZYGEMBA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9518 TIOGA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3118
Mailing Address - Country:US
Mailing Address - Phone:210-495-4888
Mailing Address - Fax:210-495-1333
Practice Address - Street 1:9518 TIOGA DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3118
Practice Address - Country:US
Practice Address - Phone:210-495-4888
Practice Address - Fax:210-495-1333
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-02
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional