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General NPI Number Information
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NPI Number | 1497987671
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Entity Type | Organization
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Legal Business Name | FAMILY GUIDANCE & WELLNESS NETWORK LLC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 130 LEWIS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5538
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Country | US
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Telephone | 702-355-3177
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Fax | 866-442-8199
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Provider Business Mailing Address
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Address Line | 130 LEWIS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5538
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Country | US
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Telephone | 702-355-3177
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Fax | 866-442-8199
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YOLANDA A. TREVINO
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Credential | PH.D.
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Telephone | 702-355-3177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0936
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License Number State | NV
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