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General NPI Number Information
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NPI Number | 1740436351
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Entity Type | Organization
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Legal Business Name | ENERGY BALANCE LLC
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 12309 CHATTANOOGA DR
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City | FRISCO
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State | TX
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Zip | 75035-7993
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Country | US
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Telephone | 214-668-9226
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Fax | 972-335-3714
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Provider Business Mailing Address
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Address Line | 12309 CHATTANOOGA DRIVE
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 214-668-9226
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Fax | 972-335-3714
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KIMBERLEY A CROSS
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Credential |
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Telephone | 214-668-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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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