Provider Demographics
NPI:1871363259
Name:ABREU, ILEANA MIGUELINA (MED LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:ILEANA
Middle Name:MIGUELINA
Last Name:ABREU
Suffix:
Gender:F
Credentials:MED LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 HAYNIE BND
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1216
Mailing Address - Country:US
Mailing Address - Phone:737-333-5594
Mailing Address - Fax:
Practice Address - Street 1:1500 HAYNIE BND
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1216
Practice Address - Country:US
Practice Address - Phone:737-333-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional