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Individual

MR. GENARO SANDOVAL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
B.A., LCDC

Contact information

Practice address
7703 N LAMAR BLVD STE 104, AUSTIN, TX 78752-1003
(512) 659-3518
(512) 252-8764
Mailing address
500 E STASSNEY LN APT 437, AUSTIN, TX 78745-3253
(512) 659-3518
(512) 252-8764

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10685
TX

Other

Enumeration date
05/19/2008
Last updated
05/05/2009
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