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Individual

MS. MARI E RIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4203 WOODCOCK DR, SUITE 265, SAN ANTONIO, TX 78228-1320
(210) 737-2674
(210) 734-2412
Mailing address
4203 WOODCOCK DR, SUITE 265, SAN ANTONIO, TX 78228-1320
(210) 737-2674
(210) 734-2412

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC14322
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
095865402
TX
05
095865403
TX
01
528735
VO PROVIDER NUMBER
TX
01
83801L
BCBS PROVIDER NUMBER
TX
Enumeration date
09/25/2006
Last updated
05/21/2008
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