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General NPI Number Information
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NPI Number | 1548897457
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Entity Type | Organization
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Legal Business Name | EMBOLDENED COUNSELING AND WELLNESS, LLC
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 11703 HUEBNER RD STE 106-422
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1201
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Country | US
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Telephone | 713-396-2306
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Fax |
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Provider Business Mailing Address
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Address Line | 11703 HUEBNER RD STE 106-422
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1201
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Country | US
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Telephone | 713-396-2306
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | STEPHANIE WANG
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Credential | LPC
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Telephone | 713-396-2306
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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 |
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License Number State |
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