Doctor Name: | CHARLENE BOGLE RISIEN |
NPI Number: | 1609213164 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCDC, AAC, CCJP, CSA |
License Number: | 7750 |
Business Practice Address: | 1800 N.e. Loop 410 #210 San Antonio, TX - 78217 |
Business Phone Number: | 2103923788 |
Business Fax Number: | |
Mailing Address: | 1800 N.e. Loop 410, #210 SAN ANTONIO |
State: | TX |
Postal Code: | 78217 |
Phone Number: | 2103923788 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2013 |
NPI Last Update Date: | 05/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 7750 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |