| NPI | 1639552383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BAEZ Mental Health Practitioner/Ed. Psyc 210-606-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 8472) |
| 103T00000X Psychologist (Licence: AZ 3556573) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 3556573) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |