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Organization
OUR LADY OF THE LAKE UNIVERSITY
Active
Organization
OUR LADY OF THE LAKE UNIVERSITY
Active
Other names
Community Counseling Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERNADETTE SOLORZANO PSYD (CLINIC DIRECTOR)
(210) 434-1054
Entity
Organization
Contact information
Practice address
590 NORTH GENERAL MCMULLEN, 3, SAN ANTONIO, TX 78228
(210) 434-1054
(210) 434-1380
Mailing address
590 NORTH GENERAL MCMULLEN, 3, SAN ANTONIO, TX 78228
(210) 434-1054
(210) 434-1380
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
16408
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446742
—
TX
Enumeration date
10/25/2006
Last updated
06/09/2008
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