Provider Demographics
NPI:1053138693
Name:PORRAS HOYOS, ALBA ANTONIETA (MA, LAC)
Entity type:Individual
Prefix:
First Name:ALBA
Middle Name:ANTONIETA
Last Name:PORRAS HOYOS
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6613 S CHINESE LANTERNS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-5274
Mailing Address - Country:US
Mailing Address - Phone:480-904-7629
Mailing Address - Fax:
Practice Address - Street 1:6613 S CHINESE LANTERNS DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-5274
Practice Address - Country:US
Practice Address - Phone:480-904-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-22334101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor