Most Relevant Information
Provider Data
| NPI Number: | 1003684739 |
| Provider Name: | ANGELICA PRISCILLA BUENTELLO GAMEROS LPC-A |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 90989 |
Most Important Dates
| Enumeration Date: | 12/12/2023 |
| Last Updated: | 02/02/2024 |
Provider Practice Location
110 VISION PARK BLVD STE 200
SHENANDOAH
TX
773843007
Practice Location Phone/Fax
| Phone: | 8323521600 |
| Fax: |
Provider Mailing Location
110 VISION PARK BLVD STE 200
SHENANDOAH
TX
773843007
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |