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General NPI Number Information
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NPI Number | 1619426467
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Entity Type | Organization
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Legal Business Name | THREE BIRDS COUNSELING & CLINICAL SUPERVISION, PLLC
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 1050 REVOLUTION MILL DR STUDIO 1C
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City | GREENSBORO
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State | NC
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Zip | 27405-5052
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Country | US
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Telephone | 336-430-6694
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 REVOLUTION MILL DR STUDIO 1C
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City | GREENSBORO
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State | NC
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Zip | 27405-5052
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Country | US
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Telephone | 336-430-6694
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Fax |
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Authorized Official
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Title or Position | OWNER & LEAD THERAPIST
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Name | MARIA ADELE BRUNELLI PAREDES
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Credential |
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Telephone | 336-430-6694
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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 | S6986
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License Number State |
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