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General NPI Number Information
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NPI Number | 1255000998
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Entity Type | Organization
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Legal Business Name | THERAPY WITH IZERIAL
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 301 S LINDSAY ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-4833
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Country | US
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Telephone | 940-222-5146
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 514
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City | GAINESVILLE
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State | TX
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Zip | 76241-0514
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Country | US
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Telephone | 940-222-5146
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS IZERIAL TOLES
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Credential |
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Telephone | 940-222-5146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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