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General NPI Number Information
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NPI Number | 1649088634
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Entity Type | Organization
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Legal Business Name | RADIANT RELATIONSHIPS COUNSELING, PLLC
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Dates
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Enumeration Date | 12/21/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 522 W RIVERSIDE AVE # 8520
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 253-780-1174
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Fax |
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Provider Business Mailing Address
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Address Line | 522 W RIVERSIDE AVE # 8520
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 909-292-5985
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | MATTHEW FREGOSO
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Credential |
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Telephone | 253-780-1174
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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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