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General NPI Number Information
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NPI Number | 1215751482
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Entity Type | Organization
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Legal Business Name | FEARLESS JOURNEY COACHING AND THERAPY
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 5000 BEE CAVES RD STE 106
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5254
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Country | US
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Telephone | 512-554-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 11917 LANSDOWNE RD
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City | AUSTIN
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State | TX
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Zip | 78754-5869
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Country | US
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Telephone | 512-554-1090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SONIA DAWN TAYLOR
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Credential | LPC
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Telephone | 512-554-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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