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General NPI Number Information
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NPI Number | 1699516963
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Entity Type | Organization
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Legal Business Name | TRUE POTENTIAL THERAPY PLLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1110 FRANKLIN TURNPIKE STE 10
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City | DANVILLE
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State | VA
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Zip | 24540
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Country | US
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Telephone | 804-930-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 2725 FRANKLIN TPKE STE F
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City | DANVILLE
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State | VA
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Zip | 24540-5365
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Country | US
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Telephone | 804-930-4720
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | FEDENA WADE
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Credential |
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Telephone | 804-930-4720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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