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Organization
HER TABLE COLLECTIVE THERAPY & WELLNESS LLC
Active
Organization
HER TABLE COLLECTIVE THERAPY & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY CHANCEY (OWNER)
(850) 565-9028
Entity
Organization
Contact information
Practice address
7314 MARY JO AVE, SOUTHPORT, FL 32409-4162
(850) 565-9028
Mailing address
7314 MARY JO AVE, SOUTHPORT, FL 32409-4162
(850) 565-9028
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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