Provider Demographics
NPI:1053027938
Name:PINA, RUBINA (LPC, MED)
Entity type:Individual
Prefix:MISS
First Name:RUBINA
Middle Name:
Last Name:PINA
Suffix:
Gender:F
Credentials:LPC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:GOODRICH
Mailing Address - State:TX
Mailing Address - Zip Code:77335-0543
Mailing Address - Country:US
Mailing Address - Phone:832-318-7431
Mailing Address - Fax:
Practice Address - Street 1:128 VISION PARK BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3018
Practice Address - Country:US
Practice Address - Phone:832-346-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional