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Organization
LIFE DESIGNS
Active
Organization
LIFE DESIGNS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M CANTRELL LPC-S (OWNER)
(210) 632-4147
Entity
Organization
Contact information
Practice address
400 N LOOP 1604 E, SUITE 175, SAN ANTONIO, TX 78232-1258
(210) 632-4147
(210) 545-4495
Mailing address
400 N LOOP 1604 E, SUITE 175, SAN ANTONIO, TX 78232-1258
(210) 632-4147
(210) 545-4495
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
12275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11864139
CAQH
TX
01
—
121917208
TPI NUMBER
TX
05
—
121917208
—
TX
Enumeration date
04/23/2012
Last updated
04/23/2012
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