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General NPI Number Information
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NPI Number | 1164288429
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Entity Type | Organization
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Legal Business Name | KOALITY COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 413 MADRID ST # 2
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City | CASTROVILLE
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State | TX
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Zip | 78009-4527
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Country | US
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Telephone | 210-262-2807
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Fax |
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Provider Business Mailing Address
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Address Line | 413 MADRID ST # 2
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City | CASTROVILLE
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State | TX
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Zip | 78009-4527
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Country | US
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Telephone | 210-262-2807
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KIMBERLEY KAY GASKILL
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Credential | EDD, LPC-S, CSC
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Telephone | 210-241-5423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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