MEDICARE: SOUTHERN BUTTERFLY PRODUCTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	71678	TX

General Provider Information

NPI Number	:	1861949109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN BUTTERFLY PRODUCTIONS

Provider Business Mailing Address
First Line	:	5700 GRANITE PKWY
Second Line	:	SUITE 200
City	:	PLANO
State	:	TX
Zip	:	75024-6622
Country	:	US
Telephone Number	:	214-387-6070
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 GRANITE PKWY
Second Line	:	SUITE 200
City	:	PLANO
State	:	TX
Zip	:	75024-6622
Country	:	US
Telephone Number	:	214-387-6070
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANET Y RICHARDSON
Credential	:	LPC
Telephone Number	:	918-640-6637

Provider Enumeration Date	:	09/02/2016
Last Update Date	:	09/02/2016

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Directions to “SOUTHERN BUTTERFLY PRODUCTIONS ” Practice Location

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