Healthcare Provider Details

I. General information

NPI: 1083171532
Provider Name (Legal Business Name): HAPPY IV THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1746 CHADWICK DR
CEDAR HILL TX
75104-3917
US

IV. Provider business mailing address

1746 CHADWICK DR
CEDAR HILL TX
75104-3917
US

V. Phone/Fax

Practice location:
  • Phone: 214-400-8785
  • Fax:
Mailing address:
  • Phone: 214-400-8785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLINY KRISTINYA JAMES
Title or Position: OWNER
Credential: LPC
Phone: 214-400-8785