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Organization
THE METAMORPHOSIS HOUSE
Active
Organization
THE METAMORPHOSIS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CILLY JORDAN LPC, LSOTP (EXECUTIVE DIRECTOR)
(512) 217-6072
Entity
Organization
Contact information
Practice address
829 N LBJ DR, SUITE 209, SAN MARCOS, TX 78666-4694
(512) 217-6072
(512) 295-4595
Mailing address
829 N LBJ DR, SUITE 209, SAN MARCOS, TX 78666-4694
(512) 217-6072
(512) 295-4595
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
98981
TX
101YP2500X
Professional Counselor
Primary
19069
TX
Other
Enumeration date
03/23/2007
Last updated
11/28/2007
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