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General NPI Number Information
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NPI Number | 1740098730
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Entity Type | Organization
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Legal Business Name | I.M. RESILIENT COUNSELING AND CONSULTING 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 | 610 UPTOWN BLVD STE 2000
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City | CEDAR HILL
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State | TX
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Zip | 75104-3528
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Country | US
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Telephone | 214-701-6742
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Fax |
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Provider Business Mailing Address
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Address Line | 610 UPTOWN BLVD STE 2000
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City | CEDAR HILL
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State | TX
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Zip | 75104-3528
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Country | US
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Telephone | 214-701-6742
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MONIQUE YVONNE HARRIS
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Credential | MA, LPC, LCDC
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Telephone | 214-701-6742
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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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