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General NPI Number Information
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NPI Number | 1689475048
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Entity Type | Organization
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Legal Business Name | INFINITE POTENTIAL FUNCTIONAL MENTAL HEALTH LLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 1000 GATTIS SCHOOL RD STE 410
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City | ROUND ROCK
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State | TX
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Zip | 78664-2569
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Country | US
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Telephone | 512-230-3740
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 GATTIS SCHOOL RD STE 410
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City | ROUND ROCK
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State | TX
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Zip | 78664-2569
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Country | US
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Telephone | 512-230-3740
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY PARKER
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Credential |
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Telephone | 512-595-6651
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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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