=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023842473
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MONARI WELLNESS AND CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2024
-----------------------------------------------------
Last Update Date | 08/28/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 612 E HONDO AVE
-----------------------------------------------------
City | DEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78016-3320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-268-6757
-----------------------------------------------------
Fax | 844-268-6757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21750 HARDY OAK BLVD STE 104
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-4946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-846-2564
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | ANNAH M GUZMAN
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 210-846-2564
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------