# SOULCIAL SANCTUARY,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Soulcial Sanctuary,LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053878108
- **Authorized official:** CHARLETTE THOMAS MASTERS DEGREE (THERAPY/MEDIATION)
- **Authorized official phone:** (407) 791-9693

## Contact information

- **Practice address:** 2051 BEACON LANDING CIR, ORLANDO, FL 32824-4373
- **Practice address phone:** (407) 791-9693
- **Mailing address:** 2051 BEACON LANDING CIR, ORLANDO, FL 32824-4373
- **Mailing address phone:** (407) 791-9693

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/25/2019
- **Last updated:** 03/04/2019