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Organization
RENEWED LIFE
Active
Organization
RENEWED LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELITA COGBURN LMHC (MENTAL HEALTH THERAPIST- OWNER)
(407) 900-3518
Entity
Organization
Contact information
Practice address
1141 PEPPERDINE LN, SANFORD, FL 32771-6646
(407) 900-3518
Mailing address
4300 W LAKE MARY BLVD STE 1010-188, LAKE MARY, FL 32746-2060
(407) 900-3518
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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