Individual
SHAYNE DOUGLASS WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFTA
Contact information
Practice address
18315 BRACKEN DR, STE 4, SAN ANTONIO, TX 78266-2953
(210) 646-4658
Mailing address
18315 BRACKEN DR, STE 4, SAN ANTONIO, TX 78266-2953
(210) 646-4658
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
202043
TX
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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