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General NPI Number Information
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NPI Number | 1770971517
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Entity Type | Organization
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Legal Business Name | VIA VIRTUAL ASSISTANT
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Dates
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Enumeration Date | 01/01/2015
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Last Update Date | 01/01/2015
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Provider Practice Location Address
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Address Line | 9191 KYSER WAY SUITE 605
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City | FRISCO
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State | TX
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Zip | 75033-1953
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Country | US
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Telephone | 972-546-2874
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Fax | 972-468-9399
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Provider Business Mailing Address
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Address Line | PO BOX 2683
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City | FRISCO
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State | TX
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Zip | 75034-0050
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Country | US
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Telephone | 972-546-2874
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Fax | 972-468-9399
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CAROLE GILMORE
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Credential |
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Telephone | 972-546-2874
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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 | 71046
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License Number State | TX
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