Individual
MARY E PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
801 W. 1ST STREET, SAN JUAN, TX 78589-2276
(956) 631-9000
(956) 631-9013
Mailing address
801 W. 1ST STREET, SAN JUAN, TX 78589-2276
(956) 787-8915
(956) 787-2021
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
61089
TX
101YM0800X
Mental Health Counselor
61089
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181047501
—
TX
Enumeration date
03/20/2007
Last updated
09/07/2011
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