Provider Demographics
NPI:1174966162
Name:TEEL-GONZALES, CHRISTINA ANN (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANN
Last Name:TEEL-GONZALES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 FALLEN LEAF LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-5657
Mailing Address - Country:US
Mailing Address - Phone:210-846-2253
Mailing Address - Fax:
Practice Address - Street 1:1800 NE LOOP 410
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5213
Practice Address - Country:US
Practice Address - Phone:210-846-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional