| Organization Name: | RESONANT EVOLUTION LLC |
| NPI Number: | 1174953483 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VIDA JUNE PHOENIX (OWNER) |
| Mailing Address: | 440 S Main St Suite A Fort Worth |
| State: | TX US |
| Postal Code: | 761042400 |
| Phone Number: | 8173683875 |
| Fax Number: | 6828411138 |
| NPI Enumeration Date: | 11/22/2013 |
| NPI Last Update Date: | 11/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 16923 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |