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General NPI Number Information
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NPI Number | 1134926546
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Entity Type | Organization
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Legal Business Name | RESET THERAPEUTIC GROUP, PLLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 14 CONSULTANT PL STE 210
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City | DURHAM
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State | NC
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Zip | 27707-6320
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Country | US
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Telephone | 336-694-3586
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Fax |
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Provider Business Mailing Address
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Address Line | 366 ARMISTEAD CT
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City | BURLINGTON
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State | NC
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Zip | 27217-9744
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Country | US
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Telephone | 336-694-3586
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | TIERRA ALLEN
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Credential | LCSW
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Telephone | 336-694-3586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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