| Https://nppes.cms.hhs.gov/iaweb/login.do | |
|
703 S Church St Bldg 2 Georgetown TX 78626-5749 | |
| (512) 591-7305 | |
| Not Available |
| Full Name | Https://nppes.cms.hhs.gov/iaweb/login.do |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 703 S Church St Bldg 2, Georgetown, Texas |
| Authorized Official Name and Position | Sonja Sharyn Cousar (CEO/FOUNDER) |
| Authorized Official Contact | 5125917305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Https://nppes.cms.hhs.gov/iaweb/login.do 703 S Church St Bldg 2 Georgetown TX 78626-5749 Ph: (254) 258-3769 | Https://nppes.cms.hhs.gov/iaweb/login.do 703 S Church St Bldg 2 Georgetown TX 78626-5749 Ph: (512) 591-7305 |
| NPI Number | 1134962319 |
|---|---|
| Provider Enumeration Date | 06/17/2024 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134962319 | NPI | - | NPPES |
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