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Organization
THE LIFE SOURCE LLC
Active
Organization
THE LIFE SOURCE LLC
Active
Other names
TLSC
Organization subpart
No
Provider details
NPI number
Authorized official
LATEASHA SKINNER LPC (CEO)
(762) 207-8218
Entity
Organization
Contact information
Practice address
3228 UNIVERSITY AVE STE 103, COLUMBUS, GA 31907-7201
(762) 207-8218
(706) 400-6478
Mailing address
3228 UNIVERSITY AVE STE 103, COLUMBUS, GA 31907-7201
(762) 207-8218
(706) 400-6478
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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