Provider Demographics
NPI:1235522830
Name:FRESH ATTITUDE COUNSELING AND THERAPY INC
Entity Type:Organization
Organization Name:FRESH ATTITUDE COUNSELING AND THERAPY INC
Other - Org Name:FACT
Other - Org Type:Other Name
Authorized Official - Title/Position:TREASURER/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-818-1707
Mailing Address - Street 1:3740 COLONY DR
Mailing Address - Street 2:STE 170
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2234
Mailing Address - Country:US
Mailing Address - Phone:210-818-1707
Mailing Address - Fax:210-641-2940
Practice Address - Street 1:3740 COLONY DR
Practice Address - Street 2:STE 170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2234
Practice Address - Country:US
Practice Address - Phone:210-818-1707
Practice Address - Fax:210-641-2940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty