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General NPI Number Information
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NPI Number | 1265779292
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Entity Type | Organization
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Legal Business Name | SHIFTING PERSPECTIVES, INC.
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 1708 COIT RD # 235
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City | PLANO
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State | TX
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Zip | 75075-5024
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Country | US
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Telephone | 469-443-0459
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Fax | 469-443-0461
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Provider Business Mailing Address
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Address Line | 1708 COIT RD # 235
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City | PLANO
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State | TX
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Zip | 75075-5024
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Country | US
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Telephone | 469-443-0459
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Fax | 469-443-0461
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY A GROSSMAN
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Credential | PH.D.
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Telephone | 469-443-0459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 31274
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License Number State | TX
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