Provider Demographics
NPI:1801673462
Name:GIRAU, MICHELLE DAWN
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DAWN
Last Name:GIRAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10723 ARCHER PT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5463
Mailing Address - Country:US
Mailing Address - Phone:210-589-8825
Mailing Address - Fax:
Practice Address - Street 1:10723 ARCHER PT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-5463
Practice Address - Country:US
Practice Address - Phone:210-589-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional