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General NPI Number Information
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NPI Number | 1003494394
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Entity Type | Organization
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Legal Business Name | TRAVELING HEART THERAPY LLC
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 2200 W PORT PLAZA DR STE 326
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3214
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Country | US
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Telephone | 636-328-5212
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Fax | 636-333-4510
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Provider Business Mailing Address
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Address Line | PO BOX 1893
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-6893
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Country | US
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Telephone | 636-328-5212
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Fax | 636-333-4510
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Authorized Official
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Title or Position | OWNER, LPC
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Name | COURTNEY COX
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Credential |
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Telephone | 636-328-5212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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