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Organization
POSITIVE IMPACT THERAPEUTIC SERVICES
Active
Organization
POSITIVE IMPACT THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARNEE CRUTCHFIELD (ADMINISTRATOR)
(832) 338-4711
Entity
Organization
Contact information
Practice address
12650 N BEACH ST STE 114, FORT WORTH, TX 76244-4245
(832) 338-4711
Mailing address
12650 N BEACH ST STE 114, FORT WORTH, TX 76244-4245
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
19337
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203432401
—
TX
Enumeration date
10/01/2013
Last updated
10/01/2013
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