Provider Demographics
NPI:1841528940
Name:INNER WELLNESS COUNSELING AND CONSULTATION PLLC
Entity type:Organization
Organization Name:INNER WELLNESS COUNSELING AND CONSULTATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-545-6860
Mailing Address - Street 1:325 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-545-6860
Mailing Address - Fax:210-545-6869
Practice Address - Street 1:325 E SONTERRA BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4054
Practice Address - Country:US
Practice Address - Phone:210-545-6860
Practice Address - Fax:210-545-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17402101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty