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General NPI Number Information
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NPI Number | 1528723145
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Entity Type | Organization
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Legal Business Name | THE WAKEFUL STATE
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 2033 MIDCREST DR
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City | PLANO
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State | TX
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Zip | 75075-8542
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Country | US
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Telephone | 469-644-3321
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Fax |
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Provider Business Mailing Address
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Address Line | 2033 MIDCREST DR
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City | PLANO
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State | TX
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Zip | 75075-8542
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Country | US
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Telephone | 469-644-3321
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Fax |
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Authorized Official
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Title or Position | FOUNDER/THERAPIST
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Name | MS. KATY ALANIZ
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Credential | LPC
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Telephone | 469-644-3321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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