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General NPI Number Information
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NPI Number | 1801448428
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Entity Type | Organization
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Legal Business Name | TOLTEC THERAPY SERVICES
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Dates
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Enumeration Date | 07/13/2019
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Last Update Date | 07/13/2019
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Provider Practice Location Address
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Address Line | 73550 ALESSANDRO DR STE 200
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City | PALM DESERT
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State | CA
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Zip | 92260-3613
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Country | US
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Telephone | 760-834-9008
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Fax | 760-834-7041
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Provider Business Mailing Address
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Address Line | 73550 ALESSANDRO DR STE 200
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City | PALM DESERT
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State | CA
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Zip | 92260-3613
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Country | US
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Telephone | 760-834-9008
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Fax | 760-834-7041
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Authorized Official
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Title or Position | OWNER
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Name | HORTENCIA DIAZ
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Credential | LMFT
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Telephone | 760-834-9008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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