Healthcare Provider Details

I. General information

NPI: 1295389575
Provider Name (Legal Business Name): URHEALINGPATH HOLISTIC COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 TEXAN TRL # 220
CORPUS CHRISTI TX
78411-1872
US

IV. Provider business mailing address

321 TEXAN TRL # 220
CORPUS CHRISTI TX
78411-1872
US

V. Phone/Fax

Practice location:
  • Phone: 361-688-7481
  • Fax:
Mailing address:
  • Phone: 361-688-7481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LILO M BURDA
Title or Position: OWNER
Credential: PHD, LPC
Phone: 361-688-7481