Deep Tides Therapy Pllc

NPI #1649076191 in Georgetown, Texas

Provider Information

NPI Number: 1649076191
Entity Type: Organization
Organization Name: Deep Tides Therapy Pllc
Primary Specialty: Social Worker
Enumeration Date: Feb 24, 2025
Last Updated: Feb 24, 2025

Practice Location

Address: 1804 E 18TH ST
City: Georgetown
State: Texas
ZIP Code: 78626-7322
Phone: (503) 754-2817

Authorized Official

Name: CORINA WOLFENSTEIN
Title: OWNER OF ENTITY
Phone: (503) 754-2817

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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