Full Name | |
---|---|
Speciality | Counselor - Mental Health |
Location | 625 Clay, Kerrville, Texas |
Authorized Official Name and Position | Fred Lee Richardson (OWNER) |
Authorized Official Contact | 8307923900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
P.o. Box 134 Comfort TX 78013-1013 Ph: (830) 792-3900 | 625 Clay Kerrville TX 78028-4586 Ph: (830) 792-3900 |
NPI Number | 1912171828 |
---|---|
Provider Enumeration Date | 04/22/2008 |
Last Update Date | 06/17/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912171828 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 9502 (Texas) | Primary |
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