Organization
PHOENIX MOON HEALING, PLLC
Active
Other names
Phoenix Moon Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY VICTORIA LUNA LMFT (OWNER)
(806) 778-1982
Entity
Organization
Contact information
Practice address
4601 50TH ST STE 201, LUBBOCK, TX 79414-3518
(806) 778-1982
Mailing address
4601 50TH ST STE 201, LUBBOCK, TX 79414-3518
(806) 778-1982
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063878015
NPI
—
01
—
1922367630
NPI
—
Enumeration date
07/30/2021
Last updated
07/30/2021
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