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General NPI Number Information
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NPI Number | 1710247226
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Entity Type | Organization
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Legal Business Name | SERENITY THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 1195 JULIETTE RD
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City | FORSYTH
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State | GA
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Zip | 31029-3010
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Country | US
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Telephone | 478-365-7393
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Fax |
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Provider Business Mailing Address
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Address Line | 111 AARON CT
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City | FORSYTH
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State | GA
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Zip | 31029-3997
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Country | US
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Telephone | 478-365-7393
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Fax | 478-994-1418
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MRS. ALLISON PARRIS OWEN
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Credential | LMFT
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Telephone | 478-365-7393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT001090
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License Number State | GA
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