A Life Transformation Center, LLC
Psychologist in Springfield, MO. Organization (NPI-2).
NPI number1396020095
StatusActive
Last updated in NPPESOct 14, 2011
Details
- NPI
- 1396020095
- Entity type
- Organization (NPI-2)
- Legal business name
- A Life Transformation Center, LLC
- Organization subpart
- No
- Enumeration date
- Oct 14, 2011
- Last updated
- Oct 14, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 2010032220 | MO | Yes |
Practice location
1531 E Bradford Pkwy Ste 304Springfield, MO 65804-6539
Phone 417-888-0861 · Fax 417-888-0857
Mailing address
1531 E Bradford Pkwy Ste 304Springfield, MO 65804-6539
Phone 417-888-0861 · Fax 417-888-0857
Authorized official
Renae M Courtney
Licensed Psychologist
4178880861
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