Organization
DEEP WATERS AUSTIN LLC
Active
Other names
Jennifer Baca LPC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MERRILL BACA DAVILA LPC (MEMBER)
(512) 939-7769
Entity
Organization
Contact information
Practice address
13740 RESEARCH BLVD STE N8, AUSTIN, TX 78750-1834
(512) 939-7769
(512) 939-7769
Mailing address
312 BRENTWOOD DR, LEANDER, TX 78641-9431
(512) 939-7769
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
71881
TX
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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