Individual
ALICIA PATRICIA MENDOZA-BONEWITS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
132 PIN OAK FOREST ST, SAN ANTONIO, TX 78232-2002
(210) 497-5602
Mailing address
132 PIN OAK FOREST ST, SAN ANTONIO, TX 78232-2002
(210) 497-5602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22784
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097135002
—
TX
Enumeration date
04/02/2007
Last updated
07/08/2007
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