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Organization
WHOLE BODY PSYCHOTHERAPY
Active
Organization
WHOLE BODY PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRI KACZUR (OWNER)
(609) 417-8777
Entity
Organization
Contact information
Practice address
4500 WILLIAMS DR STE 212-158, GEORGETOWN, TX 78633-1332
(609) 417-8777
Mailing address
4500 WILLIAMS DR STE 212-158, GEORGETOWN, TX 78633-1332
(609) 417-8777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457929655
PRIVATE INSURANCE
TX
Enumeration date
05/19/2022
Last updated
05/19/2022
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