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General NPI Number Information
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NPI Number | 1447489877
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Entity Type | Organization
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Legal Business Name | GET MOTIVATED BOOT CAMP
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 3650 NEW HOPE RD
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City | AUBREY
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State | TX
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Zip | 76227-5073
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Country | US
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Telephone | 940-365-1818
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Fax | 940-365-1863
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Provider Business Mailing Address
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Address Line | 3650 NEW HOPE RD
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City | AUBREY
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State | TX
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Zip | 76227-5073
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Country | US
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Telephone | 940-365-1818
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Fax | 940-365-1863
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Authorized Official
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Title or Position | PRES/CEO
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Name | MS. MICHELLE LYNN DIEHM
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Credential |
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Telephone | 940-365-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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