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Organization
MK NEW LIFE
Active
Organization
MK NEW LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MASAMI TANAKA KOLBENSCHLAG LMHC (PRESIDENT)
(941) 275-7966
Entity
Organization
Contact information
Practice address
3800 S TAMIAMI TRL, PARADISE PLAZA SUITE 305, SARASOTA, FL 34239-6908
(941) 275-7966
(941) 429-7705
Mailing address
3800 S TAMIAMI TRL, PARADISE PLAZA SUITE 305, SARASOTA, FL 34239-6908
(941) 275-7966
(941) 429-7705
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH9277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60054
AETNA
FL
01
—
Z148M
BCBSFL
FL
Enumeration date
05/03/2012
Last updated
05/03/2012
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