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General NPI Number Information
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NPI Number | 1346921376
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Entity Type | Organization
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Legal Business Name | INTERNAL HEALING CENTER
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 5643 FOPPIANO LOOP
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City | CONVERSE
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State | TX
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Zip | 78109-3956
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Country | US
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Telephone | 407-694-7003
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Fax |
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Provider Business Mailing Address
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Address Line | 5643 FOPPIANO LOOP
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City | CONVERSE
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State | TX
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Zip | 78109-3956
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Country | US
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Telephone | 407-694-7003
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CRYSTAL YOUNG
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Credential | LCSW
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Telephone | 407-694-7003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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