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Individual
MR. JOSE LUIS AVILA
Active
Individual
MR. JOSE LUIS AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.,.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701002091
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194789545
—
VA
01
—
31390
AETNA
VA
01
—
541598045
APS
VA
01
—
7278061
AETNA
VA
01
—
83518
VALUE OPTIONS
VA
Enumeration date
04/13/2006
Last updated
05/19/2011
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