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General NPI Number Information
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NPI Number | 1285180539
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Entity Type | Organization
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Legal Business Name | RIVER STREET COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 200 N. RIVER STREET STE. 100-H
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City | SEGUIN
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State | TX
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Zip | 78155-5607
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Country | US
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Telephone | 830-556-7267
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N. RIVER STREET STE. 100-H
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City | SEGUIN
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State | TX
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Zip | 78155-5607
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Country | US
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Telephone | 830-556-7267
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA HAIYASOSO
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Credential |
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Telephone | 830-556-7267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71110
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License Number State | TX
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