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Organization
DEEP WATERS AUSTIN LLC
Active
Organization
DEEP WATERS AUSTIN LLC
Active
Other names
Jennifer Baca LPC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MERRILL BACA DAVILA LPC (MEMBER)
(512) 939-7769
Entity
Organization
Contact information
Practice address
13740 RESEARCH BLVD STE N8, AUSTIN, TX 78750-1834
(512) 939-7769
(512) 939-7769
Mailing address
312 BRENTWOOD DR, LEANDER, TX 78641-9431
(512) 939-7769
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
71881
TX
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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