Provider Information for 1174208102
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DEANDRA BUENO LCSW
Sex: Female
NPI: 1174208102
Last Updated: 2023-06-19
Certification Date: 2023-06-17
Certification Date: 2023-06-17
Details
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NPI | 1174208102 | ||||||||
Enumeration Date | 2023-06-19 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 240 COUNTY ROAD 466 ALICE, TX 78332-7700 United States Phone: 713-226-9592 | Fax: | ||||||||
Primary Practice Address | 240 COUNTY ROAD 466 ALICE, TX 78332-7700 United States Phone: 713-226-9592 | Fax: | ||||||||
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