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Individual

MS. NICOLE R MABRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
7272 WURZBACH RD, SUITE 601, SAN ANTONIO, TX 78240-4801
(210) 615-3483
(210) 593-9863
Mailing address
7272 WURZBACH RD, SUITE 601, SAN ANTONIO, TX 78240-4801
(210) 615-3483
(210) 593-9863

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
65777
TX
103TC0700X
Clinical Psychologist
Primary
36997
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36997
PHD
TX
01
65777
LPC LICENSE
TX
Enumeration date
08/10/2012
Last updated
12/10/2015
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