MEDICARE: MICHELLE MEYER FARIAS L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	16975	TX

General Provider Information

NPI Number	:	1013112861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MEYER FARIAS L.P.C.

Provider Business Mailing Address
First Line	:	2711 GAINESBOROUGH DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-4528
Country	:	US
Telephone Number	:	210-725-5379
Fax Number	:

Provider Business Practice Location Address
First Line	:	2711 GAINESBOROUGH DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-4528
Country	:	US
Telephone Number	:	210-725-5379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	02/13/2008

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