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Organization
VALHALLA WELLNESS
Active
Organization
VALHALLA WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA JOHNSON (OWNER/LPC)
(682) 708-3460
Entity
Organization
Contact information
Practice address
8551 BOAT CLUB RD, FORT WORTH, TX 76179-3638
(682) 708-3460
(682) 708-3121
Mailing address
8551 BOAT CLUB RD, FORT WORTH, TX 76179-3638
(682) 708-3460
(682) 708-3121
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194244525
—
TX
Enumeration date
12/02/2019
Last updated
12/02/2019
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