| The Shaping: Therapeutic & Wellness Services | |
|
2324 Mill Ridge Dr Montgomery AL 36117-4780 | |
| (334) 419-4605 | |
| Not Available |
| Full Name | The Shaping: Therapeutic & Wellness Services |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2324 Mill Ridge Dr, Montgomery, Alabama |
| Authorized Official Name and Position | Angelene Clarissa Kendall-henderson (OWNER) |
| Authorized Official Contact | 3344194605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Shaping: Therapeutic & Wellness Services 2324 Mill Ridge Dr Montgomery AL 36117-4780 Ph: () - | The Shaping: Therapeutic & Wellness Services 2324 Mill Ridge Dr Montgomery AL 36117-4780 Ph: (334) 419-4605 |
| NPI Number | 1285463620 |
|---|---|
| Provider Enumeration Date | 08/01/2024 |
| Last Update Date | 12/09/2024 |
| Certification Date | 12/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285463620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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