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General NPI Number Information
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NPI Number | 1912224239
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Entity Type | Organization
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Legal Business Name | TURNING POINT LIFE DEVELOPMENT, LLC
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 1001 CYPRESS CREEK RD STE 301
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City | CEDAR PARK
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State | TX
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Zip | 78613-4469
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Country | US
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Telephone | 512-912-6609
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 223
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City | LEANDER
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State | TX
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Zip | 78646-0223
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Country | US
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Telephone | 512-912-6609
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LACY G DYKE
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Credential | MMFT, LPC
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Telephone | 512-912-6609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 63364
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 63364
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License Number State | TX
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