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General NPI Number Information
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NPI Number | 1356921217
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Entity Type | Organization
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Legal Business Name | TRANSFORMING LIFE CENTER
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 123 YATES RD
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City | KILLEEN
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State | TX
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Zip | 76549-6757
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Country | US
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Telephone | 254-702-3452
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Fax |
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Provider Business Mailing Address
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Address Line | 123 YATES RD
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City | KILLEEN
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State | TX
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Zip | 76549-6757
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Country | US
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Telephone | 254-702-3452
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Fax | 972-318-2015
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Authorized Official
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Title or Position | LPC
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Name | LADONNA HARRIS
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Credential | M.ED
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Telephone | 254-702-3452
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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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