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General NPI Number Information
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NPI Number | 1316691561
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Entity Type | Organization
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Legal Business Name | LIFE REVISED COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 1532 RAINY BRK
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City | SCHERTZ
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State | TX
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Zip | 78154-3065
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Country | US
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Telephone | 210-880-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 1532 RAINY BRK
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City | SCHERTZ
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State | TX
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Zip | 78154-3065
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Country | US
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Telephone | 210-415-3155
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MARIA LILLIAN MORALES
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Credential | MED, LPC
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Telephone | 210-880-1227
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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 |
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License Number State |
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