Provider Demographics
NPI:1497987671
Name:FAMILY GUIDANCE & WELLNESS NETWORK LLC
Entity Type:Organization
Organization Name:FAMILY GUIDANCE & WELLNESS NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-355-3177
Mailing Address - Street 1:130 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5538
Mailing Address - Country:US
Mailing Address - Phone:702-355-3177
Mailing Address - Fax:866-442-8199
Practice Address - Street 1:130 LEWIS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5538
Practice Address - Country:US
Practice Address - Phone:702-355-3177
Practice Address - Fax:866-442-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0936106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty