Basic Information
Provider Information
NPI: 1578045845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEBBER
FirstName: ROCHELLE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4203 WOODCOCK DR STE 216
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782281312
CountryCode: US
TelephoneNumber: 2105649116
FaxNumber: 2105649087
Practice Location
Address1: 4203 WOODCOCK DR STE 216
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782281312
CountryCode: US
TelephoneNumber: 2105649116
FaxNumber: 2105649087
Other Information
ProviderEnumerationDate: 09/04/2018
LastUpdateDate: 09/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X202738TXY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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