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General NPI Number Information
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NPI Number | 1629708557
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Entity Type | Organization
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Legal Business Name | REACH CORPORATION OF TEXAS INC
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 7509 MENCHACA RD UNIT 107
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City | AUSTIN
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State | TX
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Zip | 78745-6050
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Country | US
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Telephone | 512-560-1764
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Fax | 737-277-5567
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Provider Business Mailing Address
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Address Line | 7509 MENCHACA RD UNIT 107
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City | AUSTIN
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State | TX
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Zip | 78745-6050
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Country | US
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Telephone | 512-560-1764
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Fax | 737-277-5567
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ALYCIA N DEGRAFF
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Credential | PHD, LMFT-S
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Telephone | 512-560-1764
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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 |
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License Number State |
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