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General NPI Number Information
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NPI Number | 1225846116
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Entity Type | Organization
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Legal Business Name | WHASC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 1100 WILFORD HALL LOOP BLDG 4554
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City | LACKLAND AFB
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State | TX
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Zip | 78236-5638
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Country | US
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Telephone | 210-292-6255
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Fax | 210-292-7934
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Provider Business Mailing Address
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Address Line | 1100 WILFORD HALL LOOP BLDG 4554
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City | LACKLAND AFB
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State | TX
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Zip | 78236-5638
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Country | US
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Telephone | 210-292-6255
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Fax | 210-292-7934
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TILA WAN COLE
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Credential | LCSW-S
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Telephone | 210-392-6483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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