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General NPI Number Information
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NPI Number | 1326793605
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Entity Type | Organization
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Legal Business Name | IRIDESCENT INTEGRATED HEALTH
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 2520 LONGVIEW ST STE 315
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City | AUSTIN
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State | TX
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Zip | 78705-4237
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Country | US
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Telephone | 512-910-4547
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 LONGVIEW ST STE 315
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City | AUSTIN
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State | TX
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Zip | 78705-4237
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER/THERAPIST
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Name | RACHEL ANN ZIEGLER
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Credential | LCSW, BHP
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Telephone | 512-910-4547
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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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