# YAKUBOV LIFE THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heal Your Roots Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063181964
- **Authorized official:** KIRA YAKUBOV LMFT (OWNER AND THERAPIST)
- **Authorized official phone:** (484) 800-1652

## Contact information

- **Practice address:** 2617 STREET RD \# 282, BENSALEM, PA 19020-2864
- **Practice address phone:** (484) 800-1652
- **Mailing address:** 2617 STREET RD \# 282, BENSALEM, PA 19020-2864
- **Mailing address phone:** (484) 800-1652

## Taxonomy

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

## Other

- **Enumeration date:** 09/13/2021
- **Last updated:** 09/05/2022