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General NPI Number Information
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NPI Number | 1215685201
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Entity Type | Organization
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Legal Business Name | MIND BODY THERAPY PLLC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 1500 ASHWOOD RD UNIT B
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City | AUSTIN
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State | TX
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Zip | 78722-1507
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Country | US
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Telephone | 713-202-6471
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 ASHWOOD RD UNIT B
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City | AUSTIN
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State | TX
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Zip | 78722-1507
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Country | US
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Telephone | 713-202-6471
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | LIZ HUGHES
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Credential | LPC
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Telephone | 832-529-1416
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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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