Individual
MISS BERNADETTE ONTIVEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11710 PEBBLE HILLS BLVD, EL PASO, TX 79936-0802
(915) 533-7057
(905) 533-7158
Mailing address
3607 RIVERA AVE, EL PASO, TX 79905-2415
(915) 533-7057
(915) 533-7158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0122331
NM
101YP2500X
Professional Counselor
Primary
75206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VNM01103NI
VALUE OPTIONS
NM
Enumeration date
06/24/2009
Last updated
07/23/2019
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