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General NPI Number Information
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NPI Number | 1093214553
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Entity Type | Organization
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Legal Business Name | PALMER COUNSELING CONSULTING COACHING INCORPORATED
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Dates
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Enumeration Date | 02/09/2018
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 3030 NACOGDOCHES RD
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City | SAN ANTONIO
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State | TX
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Zip | 78217-4540
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Country | US
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Telephone | 210-826-9599
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Fax | 210-826-9828
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Provider Business Mailing Address
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Address Line | 9702 FALCON BAY
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City | CONVERSE
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State | TX
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Zip | 78109-2940
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Country | US
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Telephone | 210-826-9599
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Fax | 210-826-9828
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Authorized Official
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Title or Position | MEDICAL BILLING & CREDENTIALING SPE
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Name | ROCHELLE D FARRIS
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Credential |
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Telephone | 210-833-8615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 69841
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License Number State | TX
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