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Organization
LIFE SUPPORT THERAPY SERVICES LLC
Active
Organization
LIFE SUPPORT THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUIE KIRKBRIDE MSW, LSW (MANAGING PARTNER)
(740) 487-1768
Entity
Organization
Contact information
Practice address
4035 NORTHPOINTE DR UNIT B, ZANESVILLE, OH 43701-1738
(740) 487-1768
(740) 870-0086
Mailing address
PO BOX 2828, ZANESVILLE, OH 43702-2828
(740) 487-1768
(740) 870-0086
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194175497
—
OH
Enumeration date
06/16/2016
Last updated
09/10/2024
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