Provider Demographics
NPI:1770971517
Name:VIA VIRTUAL ASSISTANT
Entity type:Organization
Organization Name:VIA VIRTUAL ASSISTANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-546-2874
Mailing Address - Street 1:PO BOX 2683
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0050
Mailing Address - Country:US
Mailing Address - Phone:972-546-2874
Mailing Address - Fax:972-468-9399
Practice Address - Street 1:9191 KYSER WAY
Practice Address - Street 2:SUITE 605
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1953
Practice Address - Country:US
Practice Address - Phone:972-546-2874
Practice Address - Fax:972-468-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-01
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71046101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty