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Organization
LIFESTANCE HEALTH
Active
Organization
LIFESTANCE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA MAHA'A (OPERATIONAL MANAGER)
(407) 228-2496
Entity
Organization
Contact information
Practice address
14645 NW 77TH AVE STE 101, MIAMI LAKES, FL 33014-2569
(833) 584-1761
Mailing address
14645 NW 77TH AVE STE 101, MIAMI LAKES, FL 33014-2569
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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