Provider Demographics
NPI:1427542125
Name:AESTHETIC COUNSELING LLC
Entity Type:Organization
Organization Name:AESTHETIC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-200-4023
Mailing Address - Street 1:101 E PARK BLVD STE 1160
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8890
Mailing Address - Country:US
Mailing Address - Phone:972-200-4023
Mailing Address - Fax:972-739-3535
Practice Address - Street 1:101 E PARK BLVD STE 1160
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8890
Practice Address - Country:US
Practice Address - Phone:972-200-4023
Practice Address - Fax:972-739-3535
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AESTHETIC COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76568251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health