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NPI Code Detail

MEDICARE: MRS. DANUTA MARIA SIEMEK LCDC

MEDICARE: MRS. DANUTA MARIA SIEMEK LCDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor11753TX

General Provider Information

NPI Number : 1578986113
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DANUTA MARIA SIEMEK LCDC
Provider Business Mailing Address
First Line : 116 BRYKER DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-6008
Country : US
Telephone Number : 210-218-5506
Fax Number : 210-829-0745
Provider Business Practice Location Address
First Line : 1777 NE LOOP 410 STE 600
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78217-5218
Country : US
Telephone Number : 210-218-5506
Fax Number : 210-829-0745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2014
Last Update Date : 02/03/2014

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