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Organization
TOTAL LIFE WELLNESS PLLC
Active
Organization
TOTAL LIFE WELLNESS PLLC
Active
Other names
Total Life Wellness PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
KARA BORDEAUX MA LCPC (EXECUTIVE DIRECTOR)
(618) 616-4535
Entity
Organization
Contact information
Practice address
823 SHERIDAN LN, WATERLOO, IL 62298-3366
(618) 616-4535
Mailing address
823 SHERIDAN LN, WATERLOO, IL 62298-3366
(618) 616-4535
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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