Organization
DEEP DIVE INDIVIDUAL AND FAMILY COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHENNA DOMINIQUE FISHER LCSW-S (LCSW/OWNER)
(210) 643-4058
Entity
Organization
Contact information
Practice address
7400 BLANCO RD STE 250, SAN ANTONIO, TX 78216-4368
(210) 643-4058
(866) 544-0326
Mailing address
11300 EXPO BLVD APT 1010, SAN ANTONIO, TX 78230-1333
(210) 643-4058
(866) 544-0326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1F6319
—
TX
Enumeration date
04/03/2020
Last updated
02/11/2023
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