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General NPI Number Information
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NPI Number | 1891121968
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Entity Type | Organization
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Legal Business Name | BLISS PSYCHOTHERAPY & CONSULTING LLC
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Dates
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Enumeration Date | 09/20/2013
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Last Update Date | 02/20/2020
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Provider Practice Location Address
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Address Line | 349 KELLER PKWY STE 200
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City | KELLER
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State | TX
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Zip | 76248-2266
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Country | US
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Telephone | 817-382-2249
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Fax | 817-541-4483
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Provider Business Mailing Address
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Address Line | 349 KELLER PKWY STE 200
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City | KELLER
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State | TX
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Zip | 76248-2266
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Country | US
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Telephone | 817-382-2249
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Fax | 817-541-4483
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Authorized Official
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Title or Position | OWNER
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Name | MS. JENNIFER DELAINE TAYLOR
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Credential | LCSW
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Telephone | 720-583-5335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9923050
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License Number State | CO
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