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General NPI Number Information
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NPI Number | 1366740870
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Entity Type | Organization
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Legal Business Name | MINER COUNSELING SERVICES LTD LLP
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 3625 MANCHACA RD STE 103
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City | AUSTIN
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State | TX
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Zip | 78704-5912
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Country | US
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Telephone | 512-689-7105
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Fax | 512-527-3576
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Provider Business Mailing Address
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Address Line | 11900 QUASSIA DR
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City | AUSTIN
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State | TX
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Zip | 78739-1941
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Country | US
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Telephone | 512-689-7105
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Fax | 512-527-3576
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Authorized Official
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Title or Position | PRESIDENT OF THE GENERAL PARTNER
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Name | DR. CLAIRE JO MINER
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Credential | PH.D.
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Telephone | 512-689-7105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 13663
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License Number State | TX
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