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Organization
LIVE YOUR BEST LIFE THERAPY
Active
Organization
LIVE YOUR BEST LIFE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA N PORTER (CREDENTIALING CONSULTANT)
(443) 255-3135
Entity
Organization
Contact information
Practice address
2180 GEORGETOWN DRIVE, CORONA, CA 92881
(909) 278-8855
Mailing address
4343 MACARTHUR BLVD # 1146, NEWPORT BEACH, CA 92660-2021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
01/25/2024
Last updated
02/13/2024
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