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General NPI Number Information
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NPI Number | 1346831229
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Entity Type | Organization
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Legal Business Name | FRUIT SPRINGS COUNSELING
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 616 N MAIN ST STE 202
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City | TEMPLE
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State | TX
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Zip | 76501-3249
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Country | US
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Telephone | 254-258-7914
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Fax |
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Provider Business Mailing Address
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Address Line | 451D E CENTRAL TEXAS EXPY STE 368
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-1962
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | TERRICA JOSEPH
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Credential | LPC
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Telephone | 254-258-7914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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