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General NPI Number Information
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NPI Number | 1992288914
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Entity Type | Organization
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Legal Business Name | COPPER BRIDGE COUNSELING, PLLC
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 2324 E CESAR CHAVEZ ST
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City | AUSTIN
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State | TX
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Zip | 78702-4604
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Country | US
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Telephone | 512-632-3141
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Fax | 512-870-9789
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Provider Business Mailing Address
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Address Line | 3005 S LAMAR BLVD # D109-231
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City | AUSTIN
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State | TX
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Zip | 78704-8864
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Country | US
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Telephone | 512-632-3141
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Fax | 512-870-9789
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Authorized Official
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Title or Position | OWNER
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Name | LAURA JO ACUNA ZAVALNEY
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Credential | LCSW
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Telephone | 512-632-3141
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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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