Provider Information for 1609325505
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LEESA STARRETT WELLNESS CENTER
Organization Subpart: NO
NPI: 1609325505
Last Updated: 2016-10-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1609325505 | ||||||||
| Enumeration Date | 2016-10-03 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: LEESA STARRETT Title: LPC Phone: 8177810307 | ||||||||
| Mailing Address | 241 MEADOW CREEK LN BURLESON, TX 76028-7959 United States Phone: 817-781-0307 | Fax: | ||||||||
| Primary Practice Address | 241 MEADOW CREEK LN BURLESON, TX 76028-7959 United States Phone: 817-781-0307 | Fax: | ||||||||
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