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General NPI Number Information
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NPI Number | 1659494755
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Entity Type | Organization
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Legal Business Name | GOLDEN RESOURCES
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7338 GLEN ARBOR
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City | SAN ANTONIO
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State | TX
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Zip | 78239-3708
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Country | US
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Telephone | 210-654-4566
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Fax | 210-654-4566
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Provider Business Mailing Address
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Address Line | 7338 GLEN ARBOR
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City | SAN ANTONIO
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State | TX
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Zip | 78239-3708
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Country | US
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Telephone | 210-654-4566
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Fax | 210-654-4566
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MS. MICHELLE ANN POOLE
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Credential | LMSW
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Telephone | 210-661-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 05099
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License Number State | TX
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