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General NPI Number Information
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NPI Number | 1619161759
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Entity Type | Organization
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Legal Business Name | CHILD TRAUMA RELIEF CONSULTANTS
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 343 W HOUSTON ST STE #902
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City | SAN ANTONIO
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State | TX
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Zip | 78205
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Country | US
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Telephone | 210-223-9369
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Fax | 210-223-9369
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Provider Business Mailing Address
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Address Line | 343 W HOUSTON ST STE #902
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City | SAN ANTONIO
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State | TX
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Zip | 78205
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Country | US
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Telephone | 210-223-9369
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Fax | 210-223-9369
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR CER
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Name | MRS. LUCINDA G PEREZ
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Credential | MA LPC CTS
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Telephone | 210-223-9369
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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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