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Organization

RESONANT EVOLUTION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. VIDA JUNE PHOENIX LPC (OWNER)
(817) 368-3875
Entity
Organization

Contact information

Practice address
440 S MAIN ST, SUITE A, FORT WORTH, TX 76104-2400
(817) 368-3875
(682) 841-1138
Mailing address
1818 S HENDERSON ST, FORT WORTH, TX 76110-6415
(817) 368-3875
(682) 841-1138

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
16923
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144980302
TX
Enumeration date
11/22/2013
Last updated
11/22/2013
About Stedi
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Product
  • Claims
  • Eligibility checks
  • EDI platform