Organization
VINE BEHAVIORAL HEALTH AND WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARISSA M NAUERT PSYD (CLINICAL PSYCHOLOGIST)
(210) 900-0252
Entity
Organization
Contact information
Practice address
8000 W INTERSTATE 10 STE 626, SAN ANTONIO, TX 78230-3868
(210) 900-0252
Mailing address
8000 W INTERSTATE 10 STE 626, SAN ANTONIO, TX 78230-3868
(210) 900-0252
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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