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General NPI Number Information
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NPI Number | 1659049757
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Entity Type | Organization
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Legal Business Name | THRIVED TOGETHER LLC
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 2011 N COLLINS BLVD STE 801
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City | RICHARDSON
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State | TX
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Zip | 75080-2690
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Country | US
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Telephone | 972-656-9650
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 N COLLINS BLVD STE 801
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City | RICHARDSON
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State | TX
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Zip | 75080-2690
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Country | US
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Telephone | 972-656-9650
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Fax |
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Authorized Official
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Title or Position | COO
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Name | HEATHER POTTER
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Credential |
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Telephone | 972-656-9650
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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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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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