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General NPI Number Information
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NPI Number | 1306154281
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Entity Type | Organization
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Legal Business Name | FAMILY VIOLENCE PREVENTION SERVICES, INC.
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 7911 BROADWAY ST
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2601
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Country | US
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Telephone | 210-930-3669
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Fax | 210-821-6194
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Provider Business Mailing Address
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Address Line | 7911 BROADWAY ST
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2601
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Country | US
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Telephone | 210-930-3669
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Fax | 210-821-6194
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. MARTA B. PELAEZ
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Credential | M.A.
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Telephone | 210-930-3669
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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 | 18659
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License Number State | TX
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