Healthcare Provider Details

I. General information

NPI: 1376273524
Provider Name (Legal Business Name): TRUE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 06/12/2022
Certification Date: 06/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 RAND AVE STE B
DAPHNE AL
36526-9138
US

IV. Provider business mailing address

42150 CARLEE LN
BAY MINETTE AL
36507-8455
US

V. Phone/Fax

Practice location:
  • Phone: 251-250-9440
  • Fax:
Mailing address:
  • Phone: 251-583-6321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. SYDNEY ALEXANDRIA WASDIN
Title or Position: PRESIDENT
Credential: LPC
Phone: 251-250-9440