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General NPI Number Information
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NPI Number | 1013483809
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Entity Type | Organization
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Legal Business Name | KEYS FOR LIFE THERAPUETIC SOLUTIONS LLC
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 10/18/2018
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Provider Practice Location Address
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Address Line | 7507 MASTERS RD
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City | MANVEL
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State | TX
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Zip | 77578-4826
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Country | US
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Telephone | 281-691-2179
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Fax | 832-369-9639
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Provider Business Mailing Address
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Address Line | 7507 MASTERS RD
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City | MANVEL
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State | TX
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Zip | 77578-4826
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Country | US
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Telephone | 281-691-2179
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Fax | 832-369-9639
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TIFFANY DENISE HOWARD
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Credential | LPC
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Telephone | 281-691-2179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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