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General NPI Number Information
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NPI Number | 1114651288
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Entity Type | Organization
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Legal Business Name | ROSE QUARTZ THERAPY LLC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 220 W 10TH ST
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City | LA JOYA
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State | TX
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Zip | 78560-9051
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Country | US
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Telephone | 956-452-0168
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82
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City | LA JOYA
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State | TX
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Zip | 78560-0082
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Country | US
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Telephone | 956-452-0168
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Fax |
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Authorized Official
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Title or Position | LPC ASSOCIATE
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Name | MS. ADRIANA NORETTE RUIZ
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Credential | LPC ASSOCIATE
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Telephone | 956-862-0455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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