MEDICARE: INTEGRATIVE SOLUTIONS CENTER

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	101YM0800X	Mental Health Counselor	67043	TX

General Provider Information

NPI Number	:	1073095758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE SOLUTIONS CENTER

Provider Business Mailing Address
First Line	:	5941 FIESTA DR STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5254
Country	:	US
Telephone Number	:	915-740-8322
Fax Number	:

Provider Business Practice Location Address
First Line	:	5941 FIESTA DR STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5254
Country	:	US
Telephone Number	:	915-740-8322
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MARTAMARIA FRAPPIER
Credential	:	MA, LPC
Telephone Number	:	915-740-8322

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	08/30/2018

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