Organization
SOUL JOURNEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEE THOMAS (OWNER)
(702) 321-8984
Entity
Organization
Contact information
Practice address
8310 CHARLESTON PEAK ST, LAS VEGAS, NV 89166-5168
(702) 321-8984
Mailing address
8310 CHARLESTON PEAK ST, LAS VEGAS, NV 89166-5168
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407165681
—
NV
Enumeration date
12/19/2021
Last updated
12/19/2021
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