MEDICARE: RELATIONAL HEALING THERAPY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1669247003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELATIONAL HEALING THERAPY PLLC

Provider Business Mailing Address
First Line	:	5401 E PARMER LN APT 5335
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-9717
Country	:	US
Telephone Number	:	512-939-9666
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 E PARMER LN APT 5335
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-9717
Country	:	US
Telephone Number	:	512-939-9666
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAMILA GOMEZ
Credential	:
Telephone Number	:	512-939-9666

Provider Enumeration Date	:	11/15/2023
Last Update Date	:	11/15/2023

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