| A Life Transformation Center, Llc | |
|
1531 E Bradford Pkwy Ste 304 Springfield MO 65804-6539 | |
| (417) 888-0861 | |
| (417) 888-0857 |
| Full Name | A Life Transformation Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1531 E Bradford Pkwy Ste 304, Springfield, Missouri |
| Authorized Official Name and Position | Renae M Courtney (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4178880861 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Life Transformation Center, Llc 1531 E Bradford Pkwy Ste 304 Springfield MO 65804-6539 Ph: (417) 888-0861 | A Life Transformation Center, Llc 1531 E Bradford Pkwy Ste 304 Springfield MO 65804-6539 Ph: (417) 888-0861 |
| NPI Number | 1396020095 |
|---|---|
| Provider Enumeration Date | 10/14/2011 |
| Last Update Date | 10/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396020095 | NPI | - | NPPES |
| 1033427810 | Other | MO | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2010032220 (Missouri) | Primary |
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