Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1679549729 |
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| LBN Legal business name | THERAPENO COUNSELING AND CONGREGATIONAL WELLNESS SVS, LLC | ||||
| Authorized official | TAMMY GEORGE - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 02/28/2006 | ||||
| Last updated | 08/22/2020 - About 6 years ago | ||||
| Identifiers |
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