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General NPI Number Information
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NPI Number | 1134792682
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Entity Type | Organization
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Legal Business Name | FOUR POINTS THERAPY LLC
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 10815 RANCH ROAD 2222 BLDG 3B STE 100 #555
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City | AUSTIN
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State | TX
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Zip | 78730-1159
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Country | US
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Telephone | 512-710-9684
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Fax |
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Provider Business Mailing Address
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Address Line | 10815 RANCH ROAD 2222 BLDG 3B STE 100 #555
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City | AUSTIN
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State | TX
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Zip | 78730-1159
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Country | US
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Telephone | 512-710-9684
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | ERIK MAYE
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Credential | LMFT-A
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Telephone | 512-710-9684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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