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General NPI Number Information
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NPI Number | 1467741157
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Entity Type | Organization
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Legal Business Name | ACADEMIC AND BEHAVIOR COACHING, LLC
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Dates
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Enumeration Date | 04/03/2011
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 1117 BEDFORD RD SUITE C
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City | BEDFORD
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State | TX
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Zip | 76022-6694
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Country | US
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Telephone | 817-228-7761
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Fax |
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Provider Business Mailing Address
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Address Line | 1117 BEDFORD RD SUITE C
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City | BEDFORD
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State | TX
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Zip | 76022-6694
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Country | US
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Telephone | 817-228-7761
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. TWILA K MEYER
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Credential | M.A., L.P.C.
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Telephone | 817-228-7761
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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 | 65089
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License Number State | TX
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