Provider Demographics
NPI:1447724331
Name:CUMPIAN, DORA (MED LPC)
Entity type:Individual
Prefix:
First Name:DORA
Middle Name:
Last Name:CUMPIAN
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 LUCINO LOOP
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-3251
Mailing Address - Country:US
Mailing Address - Phone:830-968-8099
Mailing Address - Fax:
Practice Address - Street 1:2180 LUCINO LOOP
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3251
Practice Address - Country:US
Practice Address - Phone:830-968-8099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health