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Organization
TRISTAN'S LEGACY, PLLC
Active
Organization
TRISTAN'S LEGACY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD TOWNS LPC, LSOTP (EXECUTIVE DIRECTOR)
(512) 975-9547
Entity
Organization
Contact information
Practice address
1751 RIVER RUN STE 200, FORT WORTH, TX 76107-6670
(682) 708-0500
Mailing address
6075 MONTE VISTA LN APT 1621, FORT WORTH, TX 76132-5436
(512) 975-9547
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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