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Individual

MARGARITA DIANA POULAKIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CRC, LCDC

Contact information

Practice address
401 E SONTERRA BLVD, SAN ANTONIO, TX 78258-4073
(210) 560-7278
Mailing address
401 E SONTERRA BLVD, SAN ANTONIO, TX 78258-4073
(210) 560-7278

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12180
TX
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306421
MA
05
1308785
MA
01
M18684
BLUE CROSS OF MASS
MA
Enumeration date
07/07/2011
Last updated
01/09/2014
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