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General NPI Number Information
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NPI Number | 1043194368
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Entity Type | Organization
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Legal Business Name | THE SACRED INTUITION STUDIO
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 215 W UNIVERSITY AVE
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City | GEORGETOWN
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State | TX
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Zip | 78626-6739
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Country | US
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Telephone | 979-224-6346
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Fax |
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Provider Business Mailing Address
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Address Line | 505 HOLIDAY CREEK LN
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City | GEORGETOWN
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State | TX
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Zip | 78633-2150
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Country | US
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Telephone | 979-224-6346
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAULA COUNTRYMAN
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Credential |
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Telephone | 979-224-6346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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