Organization
A LIFE TRANSFORMATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENAE M COURTNEY PSY.D. (LICENSED PSYCHOLOGIST)
(417) 888-0861
Entity
Organization
Contact information
Practice address
1531 E BRADFORD PKWY STE 304, SPRINGFIELD, MO 65804-6539
(417) 888-0861
(417) 888-0857
Mailing address
1531 E BRADFORD PKWY STE 304, SPRINGFIELD, MO 65804-6539
(417) 888-0861
(417) 888-0857
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2010032220
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033427810
NPI
MO
Enumeration date
10/14/2011
Last updated
10/14/2011
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