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General NPI Number Information
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NPI Number | 1609582709
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS COUNSELING & WELLNESS PLLC
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 612 E HONDO AVE
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City | DEVINE
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State | TX
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Zip | 78016-3320
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Country | US
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Telephone | 830-444-6281
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Fax | 833-371-1451
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Provider Business Mailing Address
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Address Line | 612 E HONDO AVE
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City | DEVINE
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State | TX
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Zip | 78016-3320
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Country | US
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Telephone | 830-444-6281
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Fax | 833-371-1451
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Authorized Official
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Title or Position | OWNER
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Name | MARY RIVERA
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Credential | LPC
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Telephone | 830-444-6281
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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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