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Organization
END2BEGIN
Active
Organization
END2BEGIN
Active
Other names
KKCTX, Kind Kid's Club
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY CANTU M.A., NCC, LCDC, LPC (PRESIDENT)
(210) 834-5017
Entity
Organization
Contact information
Practice address
543 LEXINGTON PASS, CANYON LAKE, TX 78133-3268
(210) 834-5017
Mailing address
543 LEXINGTON PASS, CANYON LAKE, TX 78133-3268
(210) 834-5017
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
03/28/2025
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