| C.t. Deep Impact Llc | |
|
3100 S W S Young Dr # 10333 Killeen TX 76542-2001 | |
| (210) 343-5107 | |
| Not Available |
| Full Name | C.t. Deep Impact Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3100 S W S Young Dr # 10333, Killeen, Texas |
| Authorized Official Name and Position | Emmanuel Tamarez (OWNER) |
| Authorized Official Contact | 2103435107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C.t. Deep Impact Llc 3100 S W S Young Dr # 10333 Killeen TX 76542-2001 Ph: (210) 343-5107 | C.t. Deep Impact Llc 3100 S W S Young Dr # 10333 Killeen TX 76542-2001 Ph: (210) 343-5107 |
| NPI Number | 1093595845 |
|---|---|
| Provider Enumeration Date | 09/29/2023 |
| Last Update Date | 09/29/2023 |
| Certification Date | 09/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093595845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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