Organization
NATIVE LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BAEZ MA/MA/CSP/LCDC/CART (MENTAL HEALTH PRACTITIONER/ED. PSYC)
(210) 606-1710
Entity
Organization
Contact information
Practice address
2017 W MULBERRY AVE, SAN ANTONIO, TX 78201-4957
(210) 606-1710
Mailing address
2017 W MULBERRY AVE, SAN ANTONIO, TX 78201-4957
(210) 606-1710
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
8472
TX
101YP1600X
Pastoral Counselor
Primary
—
—
103T00000X
Psychologist
3556573
AZ
390200000X
Student in an Organized Health Care Education/Training Program
3556573
AZ
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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