Provider Demographics
NPI:1548014939
Name:AGUILERA, YNOLLAH ALTAGRACIA (LPC-A, NCC)
Entity type:Individual
Prefix:
First Name:YNOLLAH
Middle Name:ALTAGRACIA
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:LPC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21630 MILSA DR APT 2424
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2505
Mailing Address - Country:US
Mailing Address - Phone:956-588-9050
Mailing Address - Fax:
Practice Address - Street 1:18911 HARDY OAK BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4968
Practice Address - Country:US
Practice Address - Phone:210-455-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional