# TWINKLE PEDS PSYCH MEDICAL GROUP PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HerSpace Mental Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558158568
- **Authorized official:** NNENNA AWAGU (OPERATIONS ADMINISTRATOR)
- **Authorized official phone:** (210) 686-6318

## Contact information

- **Practice address:** 7666 BANDERA RD, SAN ANTONIO, TX 78238-1262
- **Practice address phone:** (210) 686-6318
- **Practice address fax:** (888) 730-7347
- **Mailing address:** 7666 BANDERA RD, SAN ANTONIO, TX 78238-1262
- **Mailing address phone:** (210) 686-6318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/22/2025
- **Last updated:** 10/13/2026