Organization · NPI-2

Blue Magnolia Counseling, LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Round Rock, TX

NPI number1790465425
StatusActive
Last updated in NPPESJul 18, 2023

Details

NPI
1790465425
Entity type
Organization (NPI-2)
Legal business name
Blue Magnolia Counseling, LLC
Organization subpart
No
Enumeration date
Jul 18, 2023
Certification date
Jul 18, 2023
Last updated
Jul 18, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

1006 Aransas Cv
Round Rock, TX 78664-4630

Phone 361-293-1147

Mailing address

1006 Aransas Cv
Round Rock, TX 78664-4630

Phone 361-293-1147

Authorized official

Sarah Marie Reardon
Owner
3612931147

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