Organization
INNOVATIVE TRAUMA THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY COOK ROVIRA M.S. (OWNER/PSYCHOTHERAPIST)
(903) 363-6516
Entity
Organization
Contact information
Practice address
220 N PARK BLVD STE 112, GRAPEVINE, TX 76051-6900
(817) 330-9730
Mailing address
220 N PARK BLVD STE 112, GRAPEVINE, TX 76051-6900
(817) 330-9730
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568739563
—
TX
05
—
1891042255
—
TX
Enumeration date
10/12/2023
Last updated
10/12/2023
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